培美曲塞联合顺铂一线治疗晚期肺腺癌的临床观察

Pemetrexed combined with cispatin as the first line therapy in advanced lung adenocarcinoma

为了观察培美曲塞联合顺铂治疗晚期(ⅢB～Ⅳ)期肺腺癌的疗效及毒副反应,选取32例晚期肺腺癌患者,应用培美曲塞500mg/m2,静脉滴入15min,d1;顺铂75mg/m2,静脉滴入,d1(培美曲塞后),21d为1个周期,至少2个周期评价疗效。32例患者均可评价疗效,CR1例,PR 10例,SD10例,PD11例,总有效率(CR+PR)为34.3%。所有患者中位疾病进展时间(TTP)为5.8个月(1.2～9.8个月),中位生存时间(OS)为12.1个月(3.8～26.5个月)。主要毒副反应为胃肠道反应65.6%,多为Ⅰ～Ⅱ度;白细胞减少41.2%,多为Ⅰ～Ⅱ度。初步研究结果提示,培美曲塞联合顺铂治疗晚期肺腺癌疗效较好,不良反应小,安全性高。

The objective of this study was to evaluate the efficacy and safety of pemetrexed combined with cispatin as the first-line therapy in advanced（stage ⅢB-Ⅳ） lung of adenocarcinoma. Thirty-two patients with advanced lung of adenocarcinoma were enrolled in this study. All patients were treated with pemetrexed 500 mg/m^2 intravenously 15 min on day 1, and cispatin 75 mg/m^2 on day 1, which were repeated every 21 days. All patients who received 2 cycles could be evaluated. Thirty-two patients were eligible for clinical response evaluation. One patient achiveved complete response （CR）, 10 patients achieved partial response（PR）, 10 paients achieved stable diease（SD）, and 11 patients achieved disease progression（PD）. The overall responds rate（CR＋PR） of the regimen was 34.3%. Median time to progression（TTP） for patients was 5.8 months（1.2-9.8 months）. The median overall survival time was 12.1 months（3.8-26.5 months）. The major toxicity were gastrointestinal response and leucopenia,65.6 % and 41.2 % respectively. In conclusion, the combination of the pemetrexed and cisplatin as a first-line therapy shows promising antitumor activity with an acceptable safety profile in patients with advanced lung of adenocarcinoma.