培美曲塞单药或联合顺铂二线治疗晚期非小细胞肺癌52例临床观察

Observation of pemetrexed single-agent or combination regimen on advanced non-small cell lung cancer:52 cases reprot

目的回顾分析培美曲塞单药或联合顺铂二线治疗晚期复发或进展的非小细胞肺癌的临床疗效及不良反应。方法经病理学或细胞学确诊,一线化疗后出现复发或进展的晚期非小细胞肺癌患者52例。所有患者分为单药治疗组24例和联合治疗组28例。单药治疗组给予培美曲塞单药治疗(培美曲塞500mg/m2,第1天,21d为1个周期),联合治疗组给予美曲塞联合顺铂治疗:(培美曲塞500mg/m2+顺铂75mg/m2,第1天,21d为1个周期)。完成2个周期以上化疗评价疗效和不良反应。结果52例患者中,完全缓解(CR)0例,部分缓解(PR)2例,稳定(SD)34例,进展(PD)16例,有效率(RR)为3.85%(2/52),疾病控制率(DCR)为69.23%(36/52)。2组疗效比较,差异无统计学意义(P>0.05)。主要不良反应为Ⅰ/Ⅱ度骨髓抑制、胃肠道反应,经对症处理后不影响化疗进行。单药治疗组好于联合用药组(P<0.05)。结论培美曲塞单药或联合顺铂二线治疗晚期非小细胞肺癌疗效较好,不良反应较轻,耐受性较好。

Objective To evaluate the efficacy and adverse of pemetrexed single-agent or pemetrexed combined with cisplatin in the treatment for advanced recurrent or progressive non-small cell lung cancer（NSCLC）.Methods Confirmed with pathology or cytology,Fifty-two patients were advanced or progressive NSCLC patients after the first line chemotherapy therapy.Single-agent regimen：patients was gave pemetrexed 500mg/m2 on the first day,21 days as one cycle;Combination regimen：patients were gave pemetrexed 500mg/m2 on the first day and cisplatin 60mg/m2 on the first day,21 days as one cycle.The chemotherapy efficacy and adverse reactions over 2 cycles were evaluated.Results There was no case with complete response in 52 patients,partial response：2 cases,stable disease：34 cases and progressive disease：16 cases.The response rate（RR）was 3.85%（2/52）and the disease control rate（DCR）was 69.23%（36/52）.Compared the efficaey of these two group,the difference was not statistically significant（P0.05）.The common side effects were grade Ⅰ/Ⅱ marrow toxicities and gastrointestinal response.However,single-agent treatment group was better than the combination group（P0.05）.Conclusion Pemetrexed or pemetrexed combined with cisplatin has better efficacy,slighter common side effect and tolerance better.