培美曲塞联合顺铂同步放疗局部晚期非小细胞肺癌疗效观察

Curative effect observation of pemetrexed combined with cisplatin and synchronous three-dimensional conformal radiotherapy for locally advanced non-small cell lung cancer

目的：观察培美曲塞联合顺铂同步三维适形放疗（3D‐CRT ）治疗局部晚期非小细胞肺癌（NSCLC ）的疗效与安全性。方法40例局部晚期NSCLC患者入组，其中39例完成放化疗，培美曲塞500 mg／m2，d1，静脉滴注，顺铂25 mg／m2，d1～3，静脉滴注；21 d为1个周期，共3个周期，同步放化疗后巩固2个周期；化疗第1天行3D‐CRT ，DT 66 Gy／33 f／45 d。靶区采用累积野照射，V20＜35％。结果39例中CR3例，PR27例，SD6例，PD3例，总有效率（RR）为76.9％，1、2年总生存率和局部控制率分别为75.2、38.5和85％。不良反应主要表现为血液学毒性，出现Ⅲ／Ⅳ度白细胞减少、贫血和血小板减少的患者分别为9、3和2例。结论3D‐CRT治疗局部晚期NSCLC近期及远期疗效均较好，不良反应低，为局部晚期NSCLC的有效方法。

Objective To observe the curative effect and security of pemetrexed combined with cisplatin and synchronous three‐dimensional conformal radiotherapy （3D‐CRT）for locally advancednon‐small cell lung cancer （NSCLC）.Methods There were 40 cases of locally adanced NSCLC patients ,among which 39 patients underwent chemoradiation ,pemetrexed 500 mg/m2 , d1 ,intravenous drip ,Cisplatin 25 mg/m2 ,d1~3 ,intravenous drip ;21 d for a cycle ,a total of three cycles ,the chemoradiation consolidate after 2 cycle .The first day of chemotherapy is 3 d‐CRT ,DT 66 Gy /33 f /45 d .Accumulated irradiation for target area was used ,V20〈35%.Results 3 of the 39 cases were CR ,27 cases were PR ,6 cases were SD ,3 cases were PD ,the total effective rate （RR） was 76 .9% .the 1 and 2 years overall survival rate and local control was 75.2 ,38.5 and 85% .The toxic side‐effect of mainly manifests hematology toxicity ,and the cases with Ⅲ /Ⅳ degree leukopenia ,anemia ,and thrombocytopenia were 9 ,3 and 2 cases .Conclusion The treatment of pemetrexed combined with cisplatin and synchronous 3D‐CRT for locally advanced NSCLC had near‐term and the long‐term effect ,low toxicity ,and it was an effective method in treating NSCLC .