培美曲塞治疗晚期非小细胞肺癌近期疗效分析

目的　观察培美曲塞治疗５０例晚期非小细胞肺癌（ＮＳＣＬＣ）患者的疗效和毒副反应。方法　收集２００６年６月至２０１０年４月接受培美曲塞化疗的５０例ＮＳＣＬＣ患者，分为单药组１３例和联合组３７例。单药组：培美曲塞５００ｍｇ／ｍ２ｄ１，ｑ３ｗ。联合组：培美曲塞５００ｍｇ／ｍ２ｄ１，卡铂（ＡＵＣ＝５）ｄ１，或顺铂２５ｍｇ／ｍ２ｄ１～ｄ３，或奈达铂８０ｍｇ／ｍ２ｄ１，ｑ３ｗ。所有患者接受至少２个周期化疗。近期疗效评价采用ＲＥＣＩＳＴ１.０标准，毒副反应评价按照ＷＨＯ毒性评定标准。生活质量评价参照孙燕提出的生活质量（ＱＯＬ）评分表。结果　５０例患者均可评价疗效，完全缓解（ＣＲ）２例，部分缓解（ＰＲ）７例，稳定（ＳＤ）２２例，进展（ＰＤ）１９例，有效率（ＲＲ）１８.０％，疾病控制率（ＤＣＲ）６２.０％。生活质量改善率达５８.０％。主要毒性反应为１～２级骨髓抑制和胃肠道反应，经对症处理后不影响化疗进行。结论　以培美曲塞为主的化疗方案治疗晚期ＮＳＣＬＣ疗效较好，可明显改善患者生活质量，且毒性反应轻，易于耐受。

Clinical efficiency of pemetrexed on advanced non-small cell lung cancer

Objective To observe the efficacy and toxicity of 50 cases of advanced non-small cell lung cancer patients treated by pemetrexed.Methods Single agent regimen： patients received pemetrexed 500 mg/m2 on day 1 with every 21 days.Combination regimen： patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 on day 1 or cisplatin 35 mg/m2 on day 1 to day 3 or nedaplatin 80 mg/m2 on day 1 by intravenous infusion with 21 days as one cycle.RECIST 1.0 standard was used to evaluate clinical efficiency,and the WHO toxicity standard was used to evaluate toxic reaction,and the QOL was used to evaluate the quality of life.Results All patients were given 162 cycles（at least 2 cycles,at most 6 cycles） and the response rate of all the patients were evaluated.There were 2 complete remission（CR）,7 partial remission（PR）,22 stable disease（SD） and 19 progressive disease（PD） in the group,the overall response rate was（RR） 18.0% and disease control rate was（DCR） 62.0%.The quality of life improvement rate was 58.0%.The major toxic reaction included neutropenia,thrombocytopenia,hypemia,nausea,and vomiting.Most of the severity of these effects was grade1-2 and well tolerated.Conclusion Chemotherapy with pemetrexed or pemetrexed combined with platinum in the treatment of advanced non-small cell lung cancer is effective,safe and well-tolerable,which can improve the patient quality of life.