培美曲塞联合顺铂一线治疗晚期肺腺癌的近期疗效与安全性观察.pdf

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1、1324中国肿瘤临床2013年第40卷第21期ChinJClinOncol2013，Vo1．40，No．21www．cjco．cn培美曲塞联合顺铂一线治疗晚期肺腺癌的近期疗效与安全性观察叶晓贤①袁瑛@沈虹②摘要目的：观察培关曲塞联合顺铂一线治疗晚期肺腺癌的近期疗效和安全性。方法：经病理确诊为肺腺癌的4l例初治(ⅢB～Ⅳ期)患者，采用培美曲塞联合顺铂全身化疗。每2个疗程进行疗效及安全性评价。结果：41例患者均可评价疗效，PR17例．sD20例．PD4例。总的客观有效率(ORR)为41．5％，疾病控制率(DCR)90I3％。其中男性

2、患者有效率显著高于女性患者(63．1％22．7％，P=0．009)。所有患者的中位PF$为11．0个月，中位0s为12．6个月。6例伴脑转移患者经化疗同步全脑放疗后的颅内病灶得到较好控制，ORR为83．3％，DCR为100．0％。安全性方面，仅4．8％的患者出现了Ⅲ～Ⅳ度的中性粒细胞减少、恶心或呕吐。结论：培美曲塞联合顺铂一线治疗晚期肺腺癌患者疗效肯定，安全性良好。男性患者的有效率明显高于女性患者。对伴有脑转移的患者，化疗同时进行全脑放疗，疗效好且未额外增加不良反应。关键词肺腺癌培美曲塞顺铂近期疗效安全性doi：10．3969／

3、j．issn．1000—8179．20130400Pemetrexedandplatinumasfirst-linechemotherapyforadvancedlungadenocarcinoma：anobservationofrecenttherapeuticeffectsandasafetyprofileXiaoxianYE，YingYUAN，HongSHENCorrespondenceto：YingYUAN；E—mail：yuanying1999@zju．edu．cnCancerChemoradiotherapyCent

4、er,NingboNo．1Hospital，Ningbo315000，China．DepartmentofMedicalOncology,SecondAfiliatedHospital，ZhejiangUniversityCollegeofMedicine，Hangzhou310009，China．Abstract0bjective：Therecenttherapeuticefectsandsafetyprofileofpemetrexedpluscisplatinasfirst—linechemotherapyinadvanc

5、edlungadenocarcinomawereevaluated．Methods：Atotalof41chemotherapy—naivelocallyadvancedormetastaticnon—smallcelllungcancerpatients，whowerediagnosedwithadenocarcinomabypathologicalexamination，wereincluded．Allpatientsreceived500mg／m2pemetrexedonday1．Atotaldoseof75mg／mcis

6、platinwasdividedintothreedailydosesadministeredover3d．Treat—mentswererepeatedeverythreeweeks．Thetherapeuticeficiencyandsafetyprofilewereevaluatedeverytwotreatmentcycles．Re-suits：All41patientswereeligiblefortheevaluationoftherapeuticeficiency．Seventeenpatientsshowedpa

7、rtialresponse20patients，showedstabledisease，andfourpatientsshoweddiseaseprogression．Theoverallresponserate(ORR)was41．5％andthediseasecon—trolrate(DCR)was90_3％．SubgroupanalysisshowedthattheORRinmaleswassignificantlyhigherthanthatinfemales(63．1％．22．7％，P=0．009)．Themedian

8、progression—freesurvivalofallpatientswas11．0months，whereasthemedianoverallsurvivalwas12．6months．Theintracraniallesionsofsixpatients