培美曲塞用于老年晚期肺腺癌二线治疗的疗效观察

Curative effect of pemetrexed as the second-line treatment of elderly advanced lung adenocarcinoma

目的探讨培美曲塞治疗老年晚期肺腺癌的疗效。方法选择2011年9月至2013年9月间收治的老年晚期肺腺癌患者90例,按照随机抽签法分A组和B组,各45例。A组患者给予培美曲塞联合卡铂治疗方案,B组患者给予单纯培美曲塞治疗,比较两组患者的治疗效果、生活质量和不良反应。结果 A组患者治疗有效率(53.3%)与B组(60.0%)间差异无统计学意义(P>0.05);A组患者中位无进展生存期为(5.9±2.4)个月,与B组患者的(6.4±1.9)个月比较,差异无统计学意义(P>0.05)。A组患者生活质量改善率为73.3%,与B组患者的75.5%比较,差异无统计学意义(P>0.05)。A组患者骨髓抑制和胃肠道反应的发生率分别为40.0%和35.5%,与B组患者(分别为31.1%和26.6%)比较,差异有统计学意义(P<0.05);A组患者肝功能损害、肾功能损害和皮疹的发生率分别为6.7%、4.4%和13.3%,与B组患者(分别为8.9%、4.4%和6.7%)比较,差异均无统计学意义(均P>0.05)。结论在老年晚期肺腺癌患者的二线治疗中,培美曲塞单药治疗疗效较好,不良反应较培美曲塞联合卡铂发生率低。

Objective To explore the curative effect of pemetrexed as the second-line treatment of elderly advanced lung adenocarcinoma. Methods Choosed 90 cases of advanced lung adenoearcino- ma patients whom hospitalized in September 2011 to September 2011, according to the random lottery, they were divided into group A and group B （ n = 45 ）. Group A were given pemetrexed plus carboplatin treatment, group B were given simply Pemetrexed treatment. Compared two groups with efficient, no disease progression period, patients＇ quality of life, bone marrow suppression, gastrointestinal reac- tions, liver and kidney impairment, skin rash. Treated by each cycle for 21 d, a total of two treatment cycle. Results The efficacy rate of group A was 53.3 % and had no significant difference with group B （60.0%） （P〉0.05）; medium progression-free survival （MPFS） of group A was （5.9 ~2.4） months and had no significant difference with group B [ （ 6.4：1：1.9 ） months ] （ P 〉 0.05 ） . About quality of life （QOL） , the improvement rate of group A was 73.3% and had no significant difference with group B75.5% （ P 〉 O. 05 ） . Bone marrow suppression （ 40.0% ） , gastrointestinal reaction （35.5 % ） in group A had significant difference with group B （bone marrow suppression 31. 1% , gas- trointestinal tract 26.6% ） （ P 〈 O. 05 ） ; liver function damage （ 6.7% ） , renal impairment （4.4%）, skin rash （13.3%） of group A had no significant difference with group B （liver damage 8.9% , kidney damage 4.4% , rash 6.7% ） （ P 〉 0.05 ）. Conclusions In the second-line treatment of patients with advanced lung adenocareinoma, pemetrexed monotherapy with good curative effect, and pemetrexed plus carboplatin can achieve low incidence of adverse reactions.