【摘要】 目的观察培美曲塞二钠联合卡铂治疗老年中晚期非小细胞肺癌的临床疗效及不良反应。方法45例住院治疗的老年(65～80岁)中晚期非小细胞肺癌患者采用培美曲塞二钠(pemetrexed disodium,PEM)、卡铂(Carboplatin,CBP)方案联合化疗,PEM:500 mg/m2,静脉滴注,第1天;CBP:300 mg/m2,静脉滴注,第1天,21 d为1周期。培美曲塞二钠24 h前口服地塞米松4 mg,2次/d,连服3 d;培美曲塞二钠前1周口服叶酸400μg,1次/d,连服直到培美曲塞结束21 d;培美曲塞二钠前1周予VitB121 000μg肌注。按RECIST疗效及毒副反应评价标准评价,完成治疗2个周期以上的患者进行临床疗效及不良反应评估,计算疾病进展时间(TTP)和总生存期(OS)。结果有效率(RR)37.8%(17/45),其中完全缓解(CR)0例,部分缓解(PR)17例,稳定(SD)22例,进展(PD)6例。中位随访8个月(2～20个月),中位TTP 7个月(1.5～12.0个月),中位OS 9个月(4～19个月),1年生存率46.7%(21/45)。毒性反应主要为骨髓抑制、胃肠道反应,均未达到Ⅲ、Ⅳ度,均可耐受,经对症处理不影响化疗进行。结论培美曲塞二钠联合卡铂方案治疗老年中晚期非小细胞肺癌患者的疗效较好,不良反应较轻,患者的耐受性好。更多还原

【Abstract】 Objective To observe the clinical efficacy and adverse effect of pemetrexed disodium(PEM) combined with Carboplatin(CBP) to treat elderly patients with intermediate or late-stage non-small cell lung cancer.Methods 45 elderly(65-80 years) patients with advanced non-small cell lung cancer were treated by combination regimen of Alimta and CBP.Results There were 45 patients available.It’s response rate was 37.8%(17/45) which included complete remission of 0 case,partial remission of 17 cases,stable disease of 22 cases and progression of 6 cases.The median TTP time was 7 months(1.5-12.0 months) and median OS time was 9 months(4-19 months) and one-year survival rate was 46.7%(21/45).Bone marrow suppression and gastrointestinal toxicity were the important adverse effects,not above Ⅲ-Ⅳ grade.Conclusions The combination regimen of PEM and CBP to treat elderly patients with intermediate or late-stage non-small cell lung cancer has better efficacy,slighter adverse effect and could be well-tolerated.更多还原