培美曲塞联合卡铂方案二线治疗老年晚期肺腺癌56例

Pemetrexed Combined with Carboplatin in Second-line Treatment of 56Elderly Patients with Advanced Pulmonary Adenocarcinoma

目的探讨培美曲塞联合卡铂方案二线治疗老年晚期肺腺癌的效果。方法对56例老年晚期肺腺癌一线GP(吉西他滨+顺铂)方案化疗失败者,采用培美曲塞联合卡铂方案二线治疗:培美曲塞500 mg/m2,第1天静脉滴注10 min,卡铂按血药浓度-时间曲线下面积(AUC)=5计算给药量,第l天静脉滴注,21 d为1个周期。至少2个周期后评价疗效,观察毒副反应。结果本组有效(完全缓解+部分缓解)率为39.3%,疾病控制(完全缓解+部分缓解+稳定)率为71.4%,无进展生存期平均5.1个月,1年生存率80.8%。主要毒副反应为轻度骨髓抑制及消化道反应,经对症处理均消失。结论培美曲塞联合卡铂方案二线治疗老年晚期肺腺癌近期效果较好,且患者耐受性好。

Objective To evaluate the effect of Pemetrexed combined with Carboplatin in second-line treatment of advanced pulmonary adenocarcinoma. Methods A total of 56 elderly patients with advanced pulmonary adenocarcino- ma unsuccessfully accepted the first-line treatment of gemcitabine ＋ cisplatin （GP） , and were given second-line treatment of Pemetrexed 500mg/m2 with 10 rain intravenously guttae （ iv gtt） on the first day, hematic area under the concentration- time curve （AUC） of Carboplatin was 5 calculational dosages with iv gtt on the first day, and three weeks was a circle. The efficacy and the side-effects were evaluated at least after two circles. Results The effective （ complete remission ＋ partial remission） rate was 39.3% , the disease control （complete remission ＋ partial remission ＋ stable） rate was 71.4% , the average non-progressive life span was 5.1 months, and the one-year survival rate was 80.8%. The main side-effects were slightly myelosuppression and alimentary canal reactions which disappeared after symptomatic treatment. Conclusion The plan of Pemetrexed combined with Carboplatin in the second line treatment of elderly patients with ad- vanced pulmonary adenocarcinoma has better effectiveness and patients＇ tolerance.