培美曲塞单药一线治疗老年晚期肺腺癌近期疗效分析

目的：观察培美曲赛单药一线治疗25例老年（〉70岁）晚期肺腺癌患者的近期疗效及毒性反应。方法：收集本院2008年8月～2009年12月25例经病理组织学和（或）细胞学检查确诊的肺腺癌患者,男8例,女17例,中位年龄74岁（范围71～78岁）,化疗方案为培美曲赛500mg/m2第1天,每3周重复。对接受2个或2个以上化疗周期的患者进行疗效及毒副反应评价。结果：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。其中完全缓解（CR）0例,部分缓解（PR）8例,稳定（SD）10例,进展（PD）7例,总有效率为（CR＋PR）32%,临床获益率为（CR＋PR＋SD）72%,1年生存率为36%。毒副反应主要为骨髓抑制及胃肠道反应,经短期对症处理后不影响下一周期化疗。结论：培美曲赛一线治疗老年晚期肺腺癌有较好临床获益率,毒副反应轻,老年患者易于耐受。

Clinical observation of pemetrexed in treating advanced adenocarcinoma of lung of elderly patients

Objective：To evaluate the clinical effect and toxicity of pemetrexed in first line of treating advanced adenocarcinoma of lung in elderly patients （70 years）. Methods：Totally 25 patients collected from our hospital between Aug. 2008 and Dec. 2009 were enrolled into the study, with adenocarcinoma of lung diagnosed by pathology or cytology. 8 were men, 17 were women, the median age was 74 years （from 71 to 78 years）. The patients received pemetrexed at a dose of 500 mg/m2, the chemotherapy was repeated every 21 days on two cycles at least. Results：Among 25 patients, 8 got PR, 10 were SD and 7 were PD, the overall response rate （CR＋PR） was 32%, the clinical benefit rate （CR＋PR＋SD） was 72%, 1 year survival rate was 36%. The main side effects were inhibition of bone marrow and gastrointestinal reaction, but were tolerable. Conclusion：The regimen of pemetrexed has well clinical benefit rate, slight adverse reaction. It can be tolerant by elderly patients.