培美曲塞联合奈达铂一线治疗老年晚期肺腺癌的临床观察

  目的  评价培美曲塞(PEM)联合奈达铂(NDP)治疗老年晚期肺腺癌的疗效和不良反应。  方法  32例年龄≥70岁初治的老年晚期肺腺癌患者, 接受PEM联合NDP方案化疗。PEM 500 mg/m2静脉滴注, 时间 > 10 min, d1;NDP 80 mg/m2静脉滴注, d1。每21天为1个治疗周期, 至少2个周期后评价疗效及不良反应。  结果  32例患者均可评价疗效和不良反应, 其中CR 0例, PR 14例, SD 13例, PD 5例, 有效率为43.8%(14/32), 中位疾病进展时间为6.6个月, 中位生存期为13.1个月, 1年生存率为57.3%。主要不良反应为贫血68.8%(22/32)、恶心呕吐62.5%(20/32)、白细胞下降59.4%(19/32)、血小板下降40.6%(13/32), 未出现与化疗相关的死亡。  结论  年龄≥70岁晚期肺腺癌患者可以耐受PEM联合NDP方案化疗, 且疗效较好, 不良反应较轻, 大部分患者可以从中获益。 

Clinical observation of pemetrexed combined with nedaplatin as the preferred treatment of elderly patients with advanced adenocarcinoma of the lung

  Objective  This study aims to evaluate the efficacy and adverse reactions of pemetrexed(PEM) combined with nedaplatin(NDP) in elderly patients with advanced lung adenocarcinoma.  Methods  A total of 32 cases of patients, aged more than 70 years, with advanced lung adenocarcinoma were treated with PEM and NDP chemotherapy as the initial treatment.PEM(500 mg/m2) was administrated by intravenous infusion, 10 min, d1;NDP(80 mg/m2) intravenous infusion, d1, 21 d for a cycle of treatment.  Results  In the evaluation of the efficacy and adverse reactions of 32 patients, the CR had 0 case, PR had 14 cases, SD had 13 cases, PD 5 cases, the effective rate was 43.8%(14/32), median time to progression was 6.6 months, median survival time was 13.1 months, and one year survival rate was 57.3%.Major adverse events were anemia(68.8%;22/32), nausea and vomiting(62.5%;20/32), leukopenia(59.4%;19/32), platelets decreased by(40.6%;13/32), constipation(21.9%;7/32), hair loss(12.5%;4/32), and elevated transaminase(9.4%;3/32);no chemotherapy-related death occurred.  Conclusion  Patients more than 70 years of age with advanced lung cancer can tolerate chemotherapy for nedaplatin(NDP) combined with pemetrexed(PEM).Moreover, the majority of patients can benefit from the effective treatment with mild adverse reactions.