单药培美曲塞二线治疗晚期非小细胞肺癌的疗效观察

Eicacy of single pemetrexed as a second-line treatment for patients with advanced non-small cell lung cancer

【摘要】目的：探讨培美曲塞二线治疗晚期非小细胞肺癌的临床疗效。方法：2008年1月--2012年1月56例接受含铂联合化疗方案一线治疗失败的ⅢB期和Ⅳ期非小细胞肺癌患者，接受单药培美曲塞（500mg／m2，d1）二线治疗，21d为1个周期。化疗2个周期后评价近期疗效和不良反应。远期指标包括中位生存期和1年生存率。结果：本组56例患者完成2～6个周期培美曲塞治疗，共178个周期，均可评价疗效。其中，完全缓解0例，部分缓解9例（16．1％），疾病稳定19例（33．9％），疾病进展28例（50．0％），客观有效率为16．1％；中位生存期为8．9个月，1年生存率为30．35％。主要不良反应为骨髓抑制和胃肠反应，严重程度较轻，均可耐受，无治疗相关死亡。结论：培美曲塞二线治疗晚期非小细胞肺癌疗效确切，且不良反应可以耐受。

Objective： To investigate the efficacy of pemetrexed as a second-line treatment for patients with NSCLC （advanced non-small cell lung cancer）. Methods： Fifty-six patients with stages IIIB - IV NSCLC, who failed in the first-line cisplatin-based chemotherapy, were enrolled in this study between January 2008 and January 2012. All the patiients received pemetrexed 500 mg/m2 on day 1 and repeated every 21 days as a second-line chemotherapy. After two cycles of chemotherapy, the clinical efficacy and the adverse effects were evaluated. The median survival time and the one-year survival rate were calculated. Results： All the patients received 2-6 cycles of the chemotherapy with a total of 1 78 cycles. All patients were evaluable. Of the 56 patients, no one achieved complete response, 9 （16.1%） achieved partial response, 10 （33.9%） achieved stable disease, 28 （50.0%） achieved progressive disease. The objective response rate was 16.1% （9/56）. The median survival time was 8.9 months, and the one-year survival rate was 30.35%. The common adverse effects were bone marrow suppression and gastrointestinal toxicities with a light severity and could be tolerable. No treatment-related deaths occurred. Conclusion： Chemotherapy with pemetrexed as a second-line treatment for advanced NSCLC has a definite efficacy, and the adverse effects can be tolerable.