培美曲塞单药或联合铂类治疗非小细胞肺癌86例分析

目的研究培美曲塞单药或联合铂类治疗局部进展或复发转移的非小细胞肺癌（non-small cell lung cancer,NSCLC）的疗效及安全性。方法回顾性分析2008年12月-2011年5月解放军总医院经组织病理学证实的局部进展或复发转移的NSCLC患者86例接受培美曲塞（Pem）500 mg/m2d1单药化疗,或者培美曲塞500 mg/m2d1联合顺铂75 mg/m2d1或卡铂AUC=5 d1联合化疗,均21 d为1周期。所有患者治疗过程中均接受叶酸、维生素B12及地塞米松治疗。结果 86例中无完全缓解病例,部分缓解10例,稳定53例,进展23例,客观缓解率11.6%（10/86）,疾病控制率73.3%（63/86）,中位无疾病进展时间为7.3月,中位生存时间为14.6月,1年生存率为45.1%。主要不良反应为Ⅰ/Ⅱ度消化道反应和白细胞减少。结论培美曲塞单药或联合铂类治疗局部进展或复发转移的NSCLC疗效确切,耐受性好。

Treatment of non-small cell lung cancer with pemetrexed alone or in combination with platinum:An analysis of 86 patients

Objective To study the curative effect and safety of pemetrexed alone or in combination with platinum in treatment of locally advanced or metastatic non-small cell lung cancer（NSCLC）.Methods Eighty-six patients with histopathology-confirmed locally advanced or metastatic NSCLC who underwent chemotherapy with pemetrexed（500 mg/m2 d1）,or pemetrexed（500 mg/m2 d1） in combination with cisplatin（75 mg/m2 d1） or carboplatin（AUC=5 d1） every 21 days in Chinese PLA General Hospital from December 2008 to May 2011 were retrospectively analyzed.The patients were also given folic acid,vitamin B12 and dexamethasone during chemotherapy.Results Among the 86 patients,no patient had complete response;10 patients had partial response;53 patients had stable disease and 23 patients had progressive disease,with an objective remission rate of 11.6%（10/86） and a disease control rate of 73.3%（63/86）.The median disease progression time was 7.3 months,the median survival time was 14.6 months,and the 1-year survival rate was 45.1%.The major adverse effects were grade Ⅰ / Ⅱ gastrointestinal reactions and leucopenia.Conclusion The curative effect of pemetrexed alone or in combination with platinum on locally advanced or metastatic NSCLC is good and the patients can well tolerate it.