培美曲塞加奈达铂联合放疗同步治疗局部晚期肺腺癌的临床观察

目的探讨培美曲塞加奈达铂联合三维适形放疗同步治疗局部晚期肺腺癌的疗效、不良反应和生存情况。方法采用培美曲塞（Pemetrexed）500mg／m2、iv、d1，奈达铂（Nedaplatin）80mg／m2、iv、d1联合三维适形放疗（3D—CRT），2Gy／F，总剂量64～70Gy治疗37例局部晚期肺腺癌患者。结果中位随访时间19．6个月，总有效率86．4％，1年、2年总生存率分别为81．3％、48．6％，中位生存时间为20．3个月，中位无进展时间为13．4个月；不良反应以放射性食管炎、放射性肺炎、骨髓抑制为主，多为Ⅰ-Ⅱ级。结论培美曲塞加奈达铂联合三维适形放疗同步治疗局部晚期肺腺癌疗效好，不良反应可耐受。

Clinical observation of radiotherapy combined with concurrent chemotherapy of pemetrexed plus nedaplatin in locally advanced lung cancer

Objective To investigate the efficacy, adverse reactions and survival of the scheme in locally advanced lung adenocarcinoma treated with pemetrexed, nedaplatin plus three dimensional conformal radiotherapy （3D-CRT）. Method 37 patients with locally advanced lung adenocarcinoma received chemotherapy of pemetrexed 500 mg/m2, iv, dl, and nedaplatin 80 mg/m2, iv, dl, with total dose of 64-70 Gy, jointing concurrent 3D-CRT. Result The median follow-up time was 19. 6 months, overall response rate was 86.4%, and 1-, 2-year overall survival rates were 81.3%, 48.6%, respectively. The overall median survival time was 20. 3 months, and the median time to progression was 13.4 months. Major adverse reactions included radiation esophagitis, radiation pneumonitis and bone marrow suppression, in which grade I - II were most common. Conclusion Patients with locally advanced lung adenocarcinoma evidently benefit from the regimen that pemetrexed plus nedaplatin with concurrent 3D-CRT, adverse reactions can be tolerated as well.