培美曲塞治疗30例晚期非小细胞肺癌患者疗效观察
Observation of uses of pemetrexed in treating patients with advanced non-small cell lung cancer
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摘要: 目的: 研究多靶点叶酸拮抗剂培美曲塞治疗晚期复发或进展非小细胞肺癌(NSCLC)的有效性和毒性反应。方法: 自2006年11月-2007年8月共收集我院30例患者,其中男性21例,女性9例,中位年龄51岁(范围36~71岁)。有组织学及细胞学证实的晚期NSCLC患者,经多次化疗后出现复发或进展,PS评分0~2分。化疗策略:培美曲塞500 mg/m2单药或联合顺铂75 mg/m2,每3周重复;对接受两次或两次以上化疗周期患者进行化疗效果评价。结果: 27例可评价疗效,无CR病例,PR 1例,SD共16例,PD共10例。全组有效率(CR+PR)为3.7%(1/27),疾病控制率(CR+PR+SD)为62.9%(17/27)。中位生存时间8个月,中位疾病进展时间为2.8个月,1年生存率为31.2%。毒副反应主要为Ⅰ~Ⅱ度胃肠道反应和骨髓抑制,如恶心、粒细胞减少及贫血。结论: 培美曲塞治疗晚期NSCLC安全有效,耐受性好。Abstract: Objective: To determine the efficacy and toxicity of pemetrexed in patients with advanced recurrent or progressive non-small cell lung cancer(Nsclc). Methods: From November 2006 to August 2007,30 patients were enrolled into this study.Among these patients,21 were male and 9 were female.The median age was 51 years(ranging from 36-71 years).All these patients had been confirmed with pathology or cytology and had failed in previous chemotherapy.PS scale was 0-2.Chemotherapy strategy: Single-agent pemetrexed 500mg/m2 or pemetrexed 500mg/m2 plus cisplatin 75mg/m2(PemCis).Pemetrexed was given on day 1 and cisplatin was given on day 2 every 3 weeks.The patient who received two or more cycles was evaluated. Results: 27 patients were evaluated.There was no case with complete response.Only 1 case got partial response,16 cases got stable disease and 10 cases got progressive disease.The responsive rate was 3.7%(1/27) and the disease controlling rate was 62.9%(17/27).The median survival time was 8 months,and the median time for progressive disease was 2.8 months with a 1-year survival rate of 31.2%.The common side effects were Grade I/II gastrointestinal response and hematologic toxicities including nausea,neutropenia and anemia. Conclusion: Pemetrexed had activity and appeared to be well-tolerated in advanced NSCLC.
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