培美曲塞联合顺铂一线治疗晚期非鳞状非小细胞肺癌的疗效观察

Efficacy of Pemetrexed Plus Cisplatin on Chemotherapy-naive Patients with Advanced Nonsquamous Non-small Cell Lung Cancer

目的观察培美曲塞联合顺铂一线治疗晚期非鳞状非小细胞肺癌的疗效及不良反应。方法 36例经组织学或细胞学确诊为非鳞状非小细胞肺癌而且未经化疗的晚期肺癌患者纳入本研究。化疗方案为:培美曲塞500 mg/m2,静脉滴注,第一天;顺铂75 mg/m2,静脉滴注,第一天或分为第一至第三天。每21天为一周期,至少接受2周期化疗,但最多不超过6周期。所有患者进行疗效及不良反应评估。结果 36例患者共化疗151周期,平均化疗周期数4.1。其中完全缓解(CR)0例,部分缓解(PR)17例,疾病稳定(SD)9例,疾病进展(PD)10例,有效率(CR+PR)为47.2%,疾病控制率(CR+PR+SD)为72.2%。中位无疾病进展生存时间为6.6月。主要不良反应为Ⅰ～Ⅱ度骨髓抑制,没有治疗相关性死亡。结论培美曲塞联合顺铂一线治疗晚期非鳞状非小细胞肺癌疗效较好而且不良反应轻。

Objective To investigate the efficacy and side effect of pemetrexed plus Cisplatin on chemotherapy-naive patients with advanced nonsquamous non-small cell lung cancer. Methods Thirty-six chemo- therapynaive patients with advanced nonsquamous non-small cell lung cancer confirmed by histology or cytology were enrolled in this study. Chemotherapy regimen： patients were given pemetrexed 500 mg/m2 on day 1 and cisplatin 75 mg/m2on dayl or 25mg/（m2·d）day 1 -3 by intravenous infusion, every 21 days as one cycle. The patients received at least 2 cycles chemotherapy,but no more than 6 cycles. The ef ficacy and side effects were evaluated. Results Thirty-six cases received 154 cycles chemotherapy with 4. 2 cycles on average. There was no case with complete response. Seventeen cases had partial response （PR） ,nine cases had stable disease（SD） and ten cases had progressive disease（PD）. The responsive rate was（CR ＋ PR）46.2% ,and the disease control rate（CR ＋ PR ＋ SD）was 72.2%. The progression free survival（PFS）time was 4.6 months. The common side effects were grade I-Ⅱ myelosuppression. There was no case with chemotherapy-related death. Conclusion Pemetrexed plus cisplatin has better efficacy in chemotherapy-naive patients with advanced nonsquamous non-small cell lung cancer, and the side effects were mild.