培美曲塞联合奈达铂方案治疗晚期非鳞非小细胞肺癌的安全性评价

Safety Evaluation of Pemetrexed Combined with Nedaplatin in the Treatment of Patients with Advanced Non-squamous Non-small Cell Lung Cancer

目的：评价培美曲塞联合奈达铂方案治疗晚期非鳞非小细胞肺癌的安全性。方法：采用回顾性分析法,对我院2013年1月-2014年4月使用培美曲塞联合奈达铂方案治疗的83例经病理组织学或细胞学检查确诊的晚期非鳞非小细胞肺癌病例进行分析。治疗方法为：培美曲塞500 mg/m2加入0.9%氯化钠注射液100 ml中静脉滴注10~15 min,d1;奈达铂75 mg/m2加入0.9%氯化钠注射液500 ml中静脉滴注,d1。21 d为1个周期。按照美国国立癌症研究院通用毒性标准4.0版（NCI-CTC v4.0）评价不良反应。结果：83例可评价患者共进行235次化疗,人均化疗2.83次,共发生不良反应102次,涉及51例患者,无因不良反应而中断治疗者。本研究中发生的不良反应主要是骨髓抑制、胃肠道反应及肝功能受损,多为Ⅰ/Ⅱ度,Ⅲ/Ⅳ度不良反应发生率较低。其中粒细胞减少发生率为32.53%,胃肠道反应（恶心、呕吐）发生率为31.32%,转氨酶异常升高发生率为15.66%。结论：培美曲塞与奈达铂联合方案安全性较好,患者易于耐受。

OBJECTIVE： To evaluate the safety of pemetrexed combined with nedaplatin in the treatment of advanced non-squa- mous non-small cell lung cancer （ANSCLC）. METHODS： Retrospective analysis was conducted to analysis the 83 patients with ANSCLC diagnosed by histological or cytological and treated by pemetrexed combined with nedaplatin in our hospital from Jan. 2013 to Apr. 2014. Patients were given pemetrexed 500 mg/m2 adding into 0.9% sodium chloride injection 100 ml for 10-15 rain, iv, dl and nedaplatin 75 mg/m2, iv, dl. 21 d was a period. NCI-CTC v4.0 toxicity and adverse reaction （ADR） evaluation stan- dard was used to evaluate the ADR. RESULTS： Totally 235 chemotherapy were conducted for the 83 evaluable patients with the av- erage of 2.83 chemotherapy; there were 102 ADRs involving 51 patients and no treatment interruption happened because of the ADR. The ADRs were mainly marrow suppression, gastrointestinal reactions and liver dysfunction, most of which were Ⅰ/ Ⅱ de- gree and the incidence of ADR with Ⅲ/Ⅳdegree was low. The incidence of neutropenia, gastrointestinal reactions （nausea and vom- iting） and abnormally elevated of transaminase was respectively 32.53 %, 31.32 % and 15,66 %. CONCLUSIONS： Pemetrexed com- bined with nedaplatin has good safety with good compliance.