培美曲塞单药或联合铂类治疗晚期复治非小细胞肺癌54例临床观察

Pemetrexed alone or combination with platinum compounds for retreatment of advanced non-small cell lung cancer:analysis of 54 cases

目的:培美曲塞是一种多靶点抗叶酸化疗药,目前已成为晚期非小细胞肺癌二线治疗的标准药物。本研究回顾分析培美曲塞单药或联合铂类治疗晚期复治非小细胞肺癌的疗效及不良反应。方法:对既往至少接受过1个标准含铂方案化疗的54例晚期非小细胞肺癌患者,分为单药治疗组21例,联合铂类治疗组33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,21天为1个周期;联合铂类治疗组给予培美曲塞联合顺铂或卡铂,培美曲塞500mg/m2,第1天,顺铂75mg/m2或卡铂AUC=5,第1天,21天为1个周期。评价疗效及不良反应。结果:54例患者均可评价疗效。单药治疗组PR1例,RR4.8%,SD10例,疾病控制率(DCR)52.4%,PD10例(47.6%)。中位无进展生存期3.8个月;联合治疗组PR4例,RR12.1%,SD20例,疾病控制率(DCR)72.7%,PD9例(27.3%)。中位无进展生存期4.8个月。与药物相关的不良反应主要为:I/II度骨髓抑制、胃肠道反应。结论:培美曲塞或与铂类联合治疗晚期复治非小细胞肺癌有效,不良反应轻微、可耐受。

Objective：Pemetrexed was approved for the second-line treatment of advanced non-small cell lung cancer as a multitarget antifolate chemotherapeutic drug.The aim of this study was to evaluate the response and adverse reaction of pemetrexed alone or pemetrexed combined with cisplatin/carboplatin in the treatment of advanced chemo-reccurrent non-small cell lung cancer.Methods：Fifty-four advanced non-small-cell lung cancer patients,which had been treated with at least 1 regimen obtained platinum previously,were treated with pemetrexed alone or pemetrexed combined with cisplatin/carboplatin.Twenty-one cases were enrolled in pemetrexed alone group,and thirty-three cases were enrolled in pemetrexed combined with cisplatin/carboplatin group.Single agent regimen：patients received pemetrexed 500mg/m^2 on day 1,with every 21 days.Combination regimen：patients received pemetrexed 500mg/m^2 and cisplatin 75mg/m^2 or carboplatin AUC=5 on day 1,with every 21 days.Results：All patients were evaluated response and toxicity.Among single agent group,CR 0 case,PR 1 case（4.8%）,RR（CR＋PR）4.8%,and SD 10 cases as their best response,disease control rate（DCR=CR＋PR＋SD）52.4%,PD 10 cases（47.6%）,the median progression-free survival time was 3.8 months.Among combination group,CR 0 case,PR 4 case（12.1%）,RR（CR＋PR）12.1%,and SD 20 cases as their best response,disease control rate（DCR=CR＋PR＋SD）72.7%,PD 9 cases（27.3%）,the median progression-free survival time was 4.8 months.The drug-related adverse reactions were grade I/II marrow toxicity and gastrointestinal response.Conclusion：Pemetrexed or pemetrexed combined with cisplatin/carboplatin is effective in advanced,previously treated non-small-cell lung cancer,and it is well tolerated with minimal adverse reactions.