培美曲塞治疗晚期肺腺癌的临床观察

 目的　观察国产培美曲塞治疗晚期肺腺癌的疗效、患者不良反应及其影响因素。方法　回顾性分析经病理组织学或细胞学检查确诊的ⅢB及Ⅳ期肺腺癌患者41例，采用培美曲塞联合顺铂方案化疗，培美曲塞二钠500 mg／m2 第1 天静脉滴注15 min，顺铂20 mg／m2 第1天至第4 天静脉滴注，每3 周重复，并口服地塞米松、叶酸和肌肉注射维生素B12预处理，所有患者至少完成2个周期治疗。观察疗效、无进展生存时间（PFS）和不良反应。结果　所有患者中位随访时间10个月，41例患者中完全缓解（CR）3例（7.3 %），部分缓解（PR）9例（22.0 %），稳定（SD）13例（31.7 %），进展（PD）16例（39.0 %），总有效率（ORR）29.3 %（12／41），疾病控制（DCR）率61.0 %（25／41）。中位PFS 5个月。年龄、性别、有无吸烟史、分期及治疗时机对ORR和DCR的影响均无统计学意义（均P＞0.05）。不同性别、有无吸烟、不同分期及不同治疗时机的PFS差异无统计学意义（均P＞0.05）。患者主要不良反应是疲乏、骨髓抑制和消化道反应，对症治疗后均能缓解。结论　培美曲塞联合顺铂方案治疗晚期肺腺癌有较好疗效，毒副作用可以被耐受。

Clinical observation on pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma

Objective　To evaluate the efficacy and drug-related toxicities of pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma. Methods　A total of 41 patients who had received pemetrexed disodium and cisplatin therapy were retrospectively reviewed. The patients were given respectively pemetrexed disodium (500 mg/m2, 1st day) and cisplatin (200 mg/m2, 1-4 day) until disease progressed. The clinical outcomes and adverse reactions were observed. Results　The CR rate was 7.3 % (3/41), PR rate was 22.0 % (9/41), SD rate was 31.7 % (13/41), PD rate was 39.0 % (16/41), the DRR was 29.3 % (12/41), DCR rate was 61.0 % (25/41), the median PFS was 5 months. The age, sex, smoking history, staging and timing of treatment had not the statistics difference on ORR and DCR. The sex, smoking history, staging and timing of treatment had not the statistical difference on PFS (P ＞ 0.05). The main toxicities were fatigue, nausea, vomiting and myelosuppression. Conclusion　The pemetrexed disodium and cisplatin are feasible and well-tolerated for advanced pulmonary adenocarcinoma patients.