培美曲塞联合奈达铂二线治疗晚期非小细胞肺癌临床观察

目的观察培美曲塞（Pemetrexed，PEM）联合奈达铂（Nedaplatin，NDP）方案二线治疗晚期非小细胞肺癌（NSCLC）的临床疗效及不良反应。方法自2003年1月～2007年8月间，收集在我院肿瘤科经4—6个周期的一线化疗后复发或转移的晚期NSCLC患者36例，给予PEM 500mg／m^2，静注，第1d，NDP 100mg／m^2，静注，第2d；21d为1疗程，两个周期化疗后评价临床疗效及不良反应，随访一年。结果入组的36例患者均可评价疗效，其中部分缓解（PR）5例，稳定（SD）14例，进展（PD）17例，有效（RR）为13．89％，稳定率为52．78％，中位生存期为10．2个月，1年存活率36．11％。主要的不良反应是骨髓抑制，白细胞下降达Ⅲ、Ⅳ度者为10例（27．78％），血小板下降达Ⅲ、Ⅳ度者5例（13．89％），血红蛋白下降达Ⅲ、Ⅳ度者4例（11．11％），胃肠道反应如恶心、呕吐占3例（8．33％），脱发、皮疹、腹泻等发生率均较低。结论培美曲塞联合奈达铂二线治疗晚期非小细胞肺癌疗效确切，且不良反应可以耐受。

Efficacy of pemetrexed combined with nedaplatin in treatment of non-small cell lung cancer patients

Objective To evaluate the efficacy and safety of chemotherapy with pemetrexed combined with nedaplatin in the treatment of advanced non-small cell lung cancer patients. Methods The study was conducted on thirty six patients with advanced NSCLC who had failed in previous chemotherapy. The 36 cases received pemetrexed 500 mg/m^2 on day 1, and nedaplatin on day 2 by intravenous infusion every 3 weeks. Results The response rates of the 36 patients was 13.89%, median survival times were 10.2 months, 1-year survival rates were 36.11%, and median progression-free survival were 4.3 months. Drug-related toxicity was generally tolerable for chemotherapy with pemetrexed combined with nedaplatin. Main adverse drug reactions of severity grade 3 or 4 were reduction of neutrophil count （27.78%） and blood platelets （13.89%） as well as red cell count （11.11%）,The side effects of alopecia, skin rash and diarrhea were significantly lower. Conclusions Chemotherapy with pemetrexed and nedaplatin is effective and feasible for advanced non-small cell lung cancer patients failed to previous chemotherapy.