培美曲塞联合卡铂治疗晚期非鳞型非小细胞肺癌的临床观察

【摘要】目的 探讨培美曲塞联合卡铂治疗晚期非鳞型非小细胞肺癌（NSCLC）的疗效及毒副反应。方法收集55例经病理组织学或细胞学确诊的晚期非鳞型NSCLC患者，接受培美曲塞联合卡铂方案化疗：培美曲塞500mg／m² 静滴，d₁；卡铂AUC=5静滴，d₁或d₂，21天为1周期。每例患者均治疗2个周期以上，观察疗效和毒副反应。结果55例患者均可评价疗效，获CR 4例，PR 14例，SD 20例，PD 17例，有效率为32.7％（18／55），疾病控制率为69.1％（38／55）；中位无进展生存时间为5.5个月（95％CI：4.4～6.6个月）。亚组分析显示，ECOG评分0～1分者较2分者和初治患者较复治者的近期疗效好（P＜.05）。主要毒副反应包括骨髓抑制、胃肠道反应、乏力和周围神经毒性，以1～2级为主。结论 培美曲塞联合卡铂方案治疗晚期非鳞型NSCLC疗效确切，毒副反应发生率低，耐受较好。

Clinical investigation on pemetrexed combined with carboplatin regimen for patients with advanced nonsquamous non-small cell lung cancer

Objective To evaluate the efficacy and side effects of pemetrexed combined with carboplatin regimen in the treat- ment for patients with advanced non-squamous non-small cell lung cancer （NSCLC）. Methods Fifty-five advanced non-squamous NSCLC patients confirmed with pathology or cytology were enrolled in this study. All the patients received pemetrexed （500mg/m~ iv dI ） and carboplatin（AUC = 5 iv d, or d2 ） with 21 days as a cycle. Each patient received at least 2 cycles. The efficacy and side effects were observed. Results The efficacy of the 55 patients could be evaluated. Four cases got CR, 14 achieved PR, 20 reached SD and 17 were PD. The effective rate was 32.7% and the disease control rate was 69.1%. The median progression free survival was 5.5 months（95% CI：4.4-6. 6 months）. The patients of ECOG score 0-1 compared with ECOG score 2, and first-line treatment compared with second-line treatment had better efficacy（P 〈0. 05）. The main side effects were myelosuppression, gastrointestinal response, fa- tigue and peripheral neurotoxicity, and mainly in grade 1-2. Conclusion Administration of pemetrexed combined with carboplatin reg- imen is beneficial to patients with advanced non-squamous NSCLC, and the toxic effects are tolerable.