培美曲塞二线或二线以上治疗老年非小细胞肺癌的临床观察

Clinical efficacy of the Second-line and beyond pemetrexed treatment in elderly patients with advanced non-small cell lung cancer

目的观察培美曲塞二线或二线以上治疗老年非小细胞肺癌的疗效及不良反应。方法回顾性分析一线及二线治疗失败的老年非小细胞肺癌21例,应用培美曲塞单药或联合顺铂或卡铂化疗,化疗1个周期后即评价不良反应;化疗2个周期后行疗效评价。结果 21例患者中20例可评价疗效,完全缓解(CR)0例,部分缓解(PR)1例,稳定(SD)12例,进展(PD)7例。客观缓解率(ORR)为5%,疾病控制率(DCR)为65%。中位无进展生存期(PFS)为3.5个月。培美曲塞血液学及非血液学副反应均较轻,主要表现为白细胞减少、血小板减少及肝功能异常,经对症及支持处理后能恢复。培美曲塞联合铂类化疗副反应略重。结论老年非小细胞肺癌患者二线或二线以上应用培美曲塞化疗有一定价值,并且副反应轻,老年患者能耐受。

Objective To evaluate the efficacy and safety of pemetrexed in the second-line and beyond treatment of advanced non-small cell lung cancerin elderly patients. Methods A total of 21 elderly patients with advanced non-small cell lung cancer were analyzed in the study, who received a combinationpemetrexed plus platinum or a single-agent after first-line or multi-line treatment. Results 20 patients were evaluable for short-term efficacy. There were 1case of partial response,12 cases of stable disease and 7 cases of progressive disease spectively.The overall objective response rate was 5% and the diseasecontrol rate was 65%. The median progression-free survival time was 3.5 months. The drug-related adverse events were myelosuppression and liver functiondamage. Conclusion Administration of pemetrexed after failure of first-line or multi-line treatment is clinically beneficial to elderly patients with advancednon-squamous NSCLC. The toxic effects of the treatment appear to be tolerable.