培美曲塞联合顺铂方案一线治疗老年晚期肺腺癌临床观察

目的:评价老年晚期肺腺癌患者接受培美曲塞(PEM)联合顺铂(DDP)方案化疗的疗效和不良反应.方法:年龄≥70岁初治的老年晚期肺腺癌患者共40例,接受PEM联合DDP方案化疗.PEM 500 mg/m2静脉滴入,＞ 10 min,d1；DDP 20.0 mg/m2静脉滴入,d1～d3.21 d为1个周期.结果:共入组40例患者,均可评价疗效和不良反应.CR 0例,PR 17例,SD 16例,PD 7例,有效率为42.5％(17/40),中位疾病进展时间为6.5个月,中位生存期为12.8个月,1年生存率为56.8％.主要不良反应为白细胞下降(60.0％)、贫血(72.5％)、血小板下降(27.5％)、恶心呕吐(67.5％)、转氨酶升高(10.0％)、脱发(15.0％)及便秘(22.5％),未出现与化疗相关的死亡.结论:年龄≥70岁晚期肺腺癌患者可以耐受PEM联合DDP方案化疗的不良反应,并可以从中获益.

Pemetrexete and cisplatin in first-line treatment of elderly advanced lung adenocarcinoma

OBJECTIVE: To evaluate the efficacy and toxicity of pemetrexete(PEM) combined with cisplatin(DDP) in the first-line treatment for elderly advanced lung adenocarcinoma patients.METHODS: Forty patients more than 70 years old with advanced lung adenocarcinoma received pemetrexete combined with cisplatin regiment as first-line treatment: PEM 500 mg/m2,d1;DDP 20.0 mg/m2,d1-d3,every 21 days.RESULTS: All were evaluable for response.The overall response rate was 42.5%(0 CR,17 PR,16 SD,7 PD).The median survival time(MST) was 12.8 months and 1 year survival rate was 56.8%.The most common toxicities were leucopenia(60.0%),anemia(72.5%),thrombocytopenia(27.5%),nausea and vomiting(67.5%),elevation of transaminase(10.0%),alopecia(15.0%) and constipation(22.5%).There were no treatment-related deaths.CONCLUSION: The elderly advanced lung adenocarcinoma patients can tolerate pemetrexete combined with cisplatin regiment and could get benefit from this regiment.