适形放疗联合培美曲塞同步治疗局部晚期老年非鳞型肺癌的临床研究

Clinical Study of Treating Locally Advanced Non-squamous Cell Lung Cancer in the Old Patients Using Conformal Irradiation Combined with Pemetrexed

目的:研究适形放疗联合培美曲塞同步治疗局部晚期老年非鳞型肺癌的疗效和副反应。方法:2009年1月始共23例患者入组行前瞻性分析,所有患者接受培美曲赛化疗联合适形放疗,对近期疗效,1年生存率和副反应采用统计学分析。结果:1)患者治疗后出现不同的近期疗效,其中CR 2例,PR 15例,NC 6例,没有PD患者。2)共有5例患者局部复发,局控率:73%,1年生存率:67%,其中ⅢA期患者1年生存率:82%;ⅢB期患者1年生存率:63%。3)副反应以Ⅰ级反应为主,只有少数Ⅱ级反应。结论:联合治疗有较好的有效性和安全性,值得进一步在老年患者肺癌治疗中推广。

Objective： The present work aims to observe the therapeutic efficacy and the side effect of chemoradiotherapy of locally advanced non-squamous cell lung cancer in the old patients using conformal irradiation combined with pemetrexed. Methods： Since January 2009, 23 older patients with locally advanced non-squamous cell lung cancer treated by conformal irradiation combined with pemetrexed were enrolled in the current work. Prospective clinical analysis of the short-term effect, 1-year survival rate, and adverse reactions was conducted. Results： Various short-term curative effects occurred in the patients after the treatment, that was, complete response in 2 of the 23 patients, partial remission in 15, and steady disease in 6. No progression of disease was found. Local recurrence occurred in 5 of the 23 patients. The rate of local control was 73%. One-year survival rate was 67% in these patients, among them the 1-year survival rate of stage Ilia patients was 82% and that of the stage ⅢB patients was 63%. Therapeutic toxicity was tolerated, in which class I reaction ranked the first among adverse reactions, and class II reaction was noted only in a few cases. Conclusion： Short-term effect is favorable and toxicity is tolerable in chemoradiotherapy of locally advanced non-squamous cell lung cancer in older patients who underwent conformal irradiation combined with pemetrexed.