培美曲塞二钠一线治疗老年Ⅳ期肺腺癌48例临床分析

目的]观察培美曲塞（pemetrexed,PEM）单药一线治疗老年晚期肺腺癌的疗效及毒性反应。方法]经细胞学或组织学确诊的48例老年晚期肺腺癌非小细胞肺癌（non small cell lung cancer,NSCLC）患者,均接受单药PEM化疗,培美曲塞二钠以500 mg/m2,第1d静脉滴注,21d为1周期,每例患者至少行2周期化疗;观察临床有效率（RR）、疾病控制率、疾病进展时间（TTP）、生活质量及化疗相关毒副反应。结果]CR 1例,PR 20例,SD 15例,PD 12例,RR43.8%,临床获益率（CBR）75.0%,平均疾病进展时间TTP 11.2月;生活质量改善50%,稳定33.3%,有效率达83.3%;化疗相关毒副反应较轻,主要为血液学毒性（骨髓抑制）和消化道反应,多为Ⅰ--Ⅱ级,无Ⅳ度毒副反应发生。结论]单药PEM一线治疗老年晚期肺腺癌具有较好的疗效,而毒性反应较轻。

Clinical Analysis of Pemetrexed Alone as First-line Drug in the Treatment of Elderly Patients 48 Cases with Advanced Lung Adenocarcinoma

Objective] To observe the efficacy and toxicity of pemetrexed alone as first-line drug in the treatment of the elderly patients with advanced lung adenocarcinoma.Methods]48 elderly patients with advanced lung adenocarcinoma confirmed by pathology or cytology were treated with pemetrexed 500 mg/m2 through intravenous drip.3 weeks was a cycle and each patient was given at least 2 cycles of chemotherapy.Results]There was only 1 case of complete remission（CR）,20 cases of partial remission（PR）,15 cases of stable disease（SD） and 12 cases of progressive disease（PD） after the treatment .The overal response rate was 43.8% and the clinical beneficial rate was 75.0%.The median time to progress（TTP） was 11.2 months. The improving of QOL was remarkable. The major adverse reactions were myelosuppression and gastrointestinal reactions .There was no chemotherapy-related death occurred. Conclusion] Pemetrexed alone in the treatment of elderly patients with advanced lung adenocarcinoma has a better efficacy with lower toxicity and good tolerance.