培美曲塞在晚期非小细胞肺癌二线及以上治疗中的疗效分析

背景与目的培美曲塞是晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)推荐的标准二线治疗方案之一。目前二线治疗之后如何选择化疗药物尚无标准。本研究旨在观察培美曲塞治疗既往接受过多程治疗的晚期NSCLC的疗效和安全性。方法回顾性分析2005年2月-2009年9月在中国协和医科大学肿瘤医院内科肺癌中心接受培美曲塞单药治疗,且既往接受过1个及以上方案治疗的37例晚期NSCLC的病例资料。结果 37例患者中二线治疗者13例(35.1%),三线及以上治疗者24例(64.9%)。疾病控制率为54.1%,其中1例(2.7%)完全缓解(双肺转移瘤消失),2例(5.4%)部分缓解,17例(45.9%)稳定,12例(32.4%)进展。中位无进展生存期为8.05个月,中位生存时间为19.29个月。毒副反应轻微。结论培美曲塞用于晚期NSCLC二线及以上治疗耐受性较好,并且有生存获益,可推荐作为二线及以上晚期NSCLC患者治疗的选择。

Efficacy of Pemetrexed as Second-line Therapy or Beyond in Patients with Advanced Non-small Cell Lung Cancer

Background and objective Pemetrexed is a standard second-line therapy in advanced non-small cell lung cancer(NSCLC).Currently,cytotoxic treatments beyond second-line therapy are not available.This study evaluated the efficacy and safety of pemetrexed as a salvage regimen in heavily pretreated patients with NSCLC. Methods Clinical data on 37 patients with advanced NSCLC who received pemetrexed as second-line therapy or beyond in Cancer Hospital of Peking Union Medical College from Feb 2005 to Sep 2009 were reviewed and analyzed retrospectively.Results Thirteen patients(35.1%)received pemetrexed as second-line treatment,whereas 24(64.9%)received it as third-line treatment or beyond. Complete response,partial response,stable disease and progressive disease were noted in 1(2.7%),2(5.4%),17(45.9%)and 12(32.4%)of the patients,respectively,with the disease control rate being 54.1%.The median duration of progression free sur-vival was 8.05 months,whereas that of overall survival was 19.29 months.Conclusion Pemetrexed is efficacious and tolerable as second-line therapy or beyond for advanced NSCLC and should thus be recommended for patients with this disease.