培美曲塞联合奈达铂二线治疗肺腺癌和肺大细胞癌的临床研究

目的观察培美曲塞联合奈达铂二线治疗晚期肺腺癌和肺大细胞癌的临床疗效。方法 32例一线治疗失败的晚期肺腺癌和肺大细胞癌患者采用培美曲塞联合奈达铂化疗4周期后,评价其疗效和不良反应。结果客观有效率为18.8%(6/32),疾病控制率为62.5%(20/32)。随访5～29个月,平均无疾病进展生存时间(PFS)为4.2个月,平均生存期(OS)为9.9个月,1年生存率为40.6%。ⅢB期客观有效率明显高于Ⅳ期,差异有统计学意义(P<0.05)。Ⅲ度以上不良反应包括白细胞减少2例(6.2%)、血红蛋白降低2例(6.2%)、血小板减少1例(3.1%)。结论培美曲塞联合奈达铂二线治疗肺腺癌和肺大细胞癌疗效确切,可提高生活质量,不良反应较轻,耐受性好,值得临床进一步推广研究。

Clinical study of pemetrexed combined with nedaplatin as second-line treatment for lung adenocarcinoma and largecell lung carcinoma

Objective To observe the clinical efficacy of pemetrexed combined with nedaplatin as second-line treatment for lung adenocarcinoma and large-cell lung carcinoma. Methods 32 cases patients with lung adenocarcinoma and largecell lung carcinoma, who had failed in first-line chemotherapy, received pemetrexed and nedaplatin chemotherapy, totally four cycles. Evaluated the efficacy and adverse effect. Results Objective response rate was 18.8% （6/32） ,disease control rate was 62.5 % （20/32）. Followed-up 5 - 29 months, the average progression-free survival （PFS） for 4.2 months, the average survival（OS） was 9.9 months, 1-year survival rate was 40.6%. Objective response rate in III period was significantly higher than that in iv period, the difference was statistically significant（ P 〈 0. 05 ）. Adverse reactions III degree above included neutropenia in 2 cases（6.2% ）, hemoglobin decreased in 2 cases （6.2%）, thrombocytopenia in 1 cases （3.1% ）. Conclusion The combination chemotherapy of pemetrexed and nedaplatin as primary therapy for patients with lung adenocarcinoma and large-cell lung carcinoma who have failed first-line chemotherapy is effective and well-tolerated and mild toxicity. It may remarkably improve quality of life and be worthy to further clinical trial.