培美曲塞二线治疗老年非鳞非小细胞肺癌的回顾分析

目的:观察培美曲塞二线治疗老年非鳞非小细胞肺癌(NSCLC)的疗效和不良反应。方法:收集我院从2012年7月至2013年4月住院治疗的70岁以上的晚期非鳞NSCLC患者58例并进行疗效和不良反应回顾性分析。患者均为一线化疗失败或不能耐受者。采用培美曲塞500mg·m-2静脉滴注,每3周1次,共6个周期。结果:本组完全缓解(CR)0例,部分缓解(PR)6例,疾病稳定(SD)20例,SD持续时间大于6个月的12例,疾病进展(PD)32例。总有效率(RR=CR+PR)为10.3%,临床获益率(CR+PR+SD>6个月)为31.0%,中位无疾病进展时间(PFS)为3.4个月(2.0⁸.9个月)。完成6周期治疗的患者10例。主要毒性反应为骨髓抑制、胃肠反应和疲劳。结论:70岁以上的、一线化疗失败的非鳞NSCLC患者能从二线培美曲塞治疗中获益,耐受性良好。

Efficacy and safety of pemetrexed as the second-line therapy in elderly patients with advanced non-squamous non-small cell lung cancer

Objective： To investigate the efficacy and safety of pemetrexed as the second-line therapy in patients older than 70 years with advanced non-squamous non-small cell lung cancer.Methods： In a single-centre,pemetrexed as the second-line therapy trial,a total of 58 patients older than 70 years with advanced non-squamous non-small cell lung cancer,failed in their first-line treatment because of progressive disease or severe adverse events,were assigned to receive pemetrexed 500mg/m2 every 3 week,iv,for 6 cycles.Results： Complete remission（CR） occurred in 0 patients,partial remissions（PR） in 6 patients,stable diseases（SD） in 20 patients,SD lasting more than 6 months in 12 patients and progressive diseases（PD） in 32 patients.total response rate（RR） occurred in 10.3% of patients,and clinical benefit（CR＋PR＋SD6 months） 31.0%.The median progression free survival（PFS） was 3.4（28.9） months.Ten patients completed 6-cycle treatment.Predominant toxicity were neutropenia,nausea and fatigue.Conclusion： Pemetrexed as second-line therapy appears to be an efficient and well-tolerated regimen in patients older than 70 years with advanced non-squamous non-small cell lung cancer.