【作者】 蒲骁麟； 王峻； 李薇； 陆彬彬； 王朝霞； 杨民； 樊卫飞； 王琳； 许菊青；

【Author】 PU Xiao-lin,WANG Jun,LI Wei,LU Bin-bin,WANG Zhao-xia,YANG Min,FAN Wei-fei (Department of Oncology,Jiangsu Province Geriatric Hospital,Nanjing,210024,China)

【机构】 江苏省老年医院； 南京医科大学第一附属医院肿瘤科； 南京医科大学第二附属医院肿瘤科；

【摘要】 [目的]探索培美曲塞单药在老年晚期非鳞型非小细胞肺癌(NSCLC)一线治疗的疗效及毒副反应。[方法]回顾性分析一线接受培美曲塞单药治疗的老年晚期非鳞型NSCLC患者,所有患者接受培美曲塞500mg/m~2静脉滴注,每21d 1个周期,每2个周期评价疗效,直至出现疾病进展或严重毒副反应,观察每例患者的疗效、副反应和最终转归。[结果]87例患者符合入组条件,共完成培美曲塞化疗392个周期,平均每人化疗4.5个周期。化疗2个周期后,PR 39例,SD 18例,有效率44.8%(39/87),疾病控制率65.5%(57/87)。整组患者的中位总生存时间(OS)为16.1个月(95%CI:13.2～19.0),中位无进展生存时间(PFS)为3.2个月(95%CI3.0～3.4个月)。25例患者完成4周期化疗,32例患者完成6个及以上周期培美曲塞化疗。完成培美曲塞化疗4周期以上的患者,其中位OS为17.4个月(95%CI:15.5～19.3);完成培美曲塞化疗≤4周期者,其中位OS为13.6个月(95%CI:11.2～16.0),两者比较,有显著差异(x~2=4.374,P=0.036)。毒副反应包括骨髓抑制、乏力和胃肠道反应,以1～2级为主,无治疗相关性死亡。[结论]培美曲塞用于老年晚期非鳞型NSCLC的一线治疗,疗效确切,毒副反应发生率低,耐受较好。患者的预后与接受培美曲塞化疗周期数相关。更多还原

【Abstract】 [Purpose]To evaluate the efficacy and toxicity of pemetrexed as first-line treatment in elderly patients with advanced non-squamous non-small-cell lung cancer(NSCLC).[Methods]The elderly patients with advanced non-squamous NSCLC received pemetrexed(500 mg/m~2,every 3 weeks in one cycle) as firstline treatment.The results of the treatments were evaluated every two cycles and the treatments would be continued until disease progress or serious side-effect occurred.[Results]87 patients were enrolled in the research,totally receiving 392 cycles of chemotherapy.The average number of chemotherapy cycles for one patient was 4.5(range 2-12).After 2 cycles of chemotherapy,no complete response was observed,while partial response was achieved in 39 patients,and stable disease in 18 patients(disease control rate:65.5%).25 patients received 4 cycles of chemotherapy and 32 patients received 6 or even more cycles.The median overall survival and progression-free survival were 16.1 months(95%CI:13.2-19.0) and 3.2 months(95% CI3.0-3.4个月)respectively.Patients received more than 4 cycles of pemetrexed chemotherapy had superior OS to those received 4 or fewer cycles,which were 17.4months(95%CI:15.5~19.3)versus 13.6months (95%CI:11.2~16.0)(x~2=4.374,P=0.036).The most frequendy occurred side effect was myelosuppression, followed by fatigue and gastro- intestinal response,which were mainly in grade l~2,and no treatment- related deaths occurred.[Conclusion]Pemetrexed showed favorable antitumor activity with mild toxicity as the first-line treatment in elderly patients with advanced nonsquamous NSCLC.更多还原