培美曲塞单药治疗老年晚期复发肺腺癌患者近期疗效分析

Short-term curative effect analysis of pemetrexed monotherapy in treatment of elderly patients with late period recurrent lung adenocarcinoma

目的分析培美曲塞单药治疗老年晚期肺腺癌患者的近期疗效和不良反应。方法 40例经过多周期化疗或分子靶向治疗后肿瘤进展的老年晚期肺腺癌患者,培美曲塞500 mg/m2静脉滴注,第1天,每21天为1个周期,并口服地塞米松、叶酸和肌内注射维生素B12以减轻不良反应。完成2个周期以上化疗后评价疗效和不良反应。根据实体瘤疗效评价标准(RECIST)对客观缓解率进行评价。结果 40例患者中,部分缓解13例(32.5%),疾病稳定15例(37.5%),疾病进展12例(30.0%),最常见的不良反应为I^II度骨髓抑制。非血液学毒性反应较轻,患者耐受性良好。结论对于老年晚期复发肺腺癌患者,给予培美曲塞解救治疗有临床获益。

Objective To analyze short-term effect and adverse reactions of pemetrexed monotherapy in treatment of elderly patients with late period recurrent lung adenocarcinoma. Methods A total of 40 advanced elderly patients with pulmonary adenocarcinoma after failure to treatment with EGFR-tyrosine kinase inhibitors and multiple cycles of chemotherapy were studied retrospectively. All patients were given pemetrexed 500 mg/m2 by the intravenous administration on the first day, with 21 days as a cycle. Dexamethasone, folic acid and vitamin B12 were applied to relieve the adverse reactions. The curative effect and adverse reactions were assessed after two therapeutic cycles. Objective response rate was estimated by response evaluation criteria in solid tumors （RECIST）. Results Among the 40 cases, there were 13 cases of partial response （32.5%）, 15 cases of stable disease （37.5%）, and 12 cases of progressive disease （30.0%）. The most common adverse reactions were myelosuppression with grade I and grade II. Other non haematological adverse reactions were tolerable for patients. Conclusion Pemetrexed is clinically beneficial for elderly patients with recurrent pulmonary adenocareinoma.