培美曲塞联合铂类药物治疗老年晚期肺腺癌的疗效与安全性分析

Efficacy and safety of platinum-based pemetrexed for elderly patients with advanced adenocarcinoma lung cancer

目的:本试验旨在评价70岁以上老年晚期肺腺癌患者一线应用培美曲塞联合铂类药物化疗的疗效和安全性。方法:试验纳入70岁以上ⅢB或Ⅳ期、既往未接受过化疗的晚期肺腺癌,接受培美曲塞联合顺铂或卡铂每3周1次治疗直到病情进展,对其疗效和安全性进行回顾性分析。结果:研究共入组22例老年患者,疗效评价完全缓解0例,部分缓解8例(36.4%),稳定12例(54.5%),进展2例(9.1%),疾病控制率90.9%。全组患者的中位PFS为5.9个月。18例(86.4%)出现1/2级的血液学或非血液学毒性,3例(13.6%)出现3/4级血液学毒性(中性粒细胞减少或贫血)和3级胃肠道反应。结论:培美曲塞联合铂类药物化疗方案对一般状态好的70岁以上老年晚期肺腺癌患者有较好的疗效和耐受性,可以作为其一线化疗的治疗选择。

Objective： The aim of this study is to discuss the efifcacy and safety of platinum-based pemetrexed as ifrst-line therapy for elderly patients aged≥70 years with advanced adenocarcinoma lung cancer.Methods： We had enrolled elderly patients aged≥70 years with Stage IIIB or IV adenocarcinoma lung cancer. Patients received pemetrexed plus cisplatin or carboplatin intravenously every 3 weeks until disease progression. The clinical data of efifcacy and safety were analyzed retrospectively.Results：22 elderly patients were assessed in this study. Partial response, stable disease, and progress disease were noted in 8 （36.4%）, 12（54.5%）, and 2（9.1%） of the patients, respectively, with the disease control rate being 90.9%. The median progression-free survival was 5.9 months. 1/2 grade hematology toxicity or non-hematology toxicity developed in 18 patients（86.4%）. 3/4 grade hematology toxicity and gastrointestinal adverse reactions occurred in 3 patients（13.6%）.Conclusion： Platinum-based pemetrexed chemotherapy could be the ifrst-line option for the elderly patients aged≥70 years who had good performance status with adenocarcinoma lung cancer for its therapeutic effect and tolerance.