摘要
目的探讨老年Ⅳ期肺腺癌患者采用国产培美曲塞联合卡铂一线治疗的疗效及安全性。方法 2009年7月至2011年12月收治49例老年Ⅳ期肺腺癌患者,给予国产培美曲塞联合卡铂一线化疗,具体方案为:培美曲塞500mg/m2静滴,d1;卡铂AUC=5静滴,d1,21天为1个周期。每2个周期评价近期疗效并随访远期疗效,对相关指标的疗效进行分层分析,记录毒副反应。结果 48例患者可评价疗效,获PR11例,SD20例,PD17例,有效率(RR)为22.9%,疾病控制率(DCR)为64.6%;48例可评价疗效的患者均获随访,中位无进展生存时间(PFS)为6.5个月(95%CI:5.7～7.3个月),中位总生存时间(OS)为11.3个月(95%CI:10.6～11.9个月);将年龄、性别、ECOGPS评分、吸烟状态、转移器官数目以及有无骨转移、恶性胸腔积液、脑转移共8个指标分层,其中ECOGPS评分、吸烟状态、转移器官数目分层间RR、PFS或OS的差异有统计学意义(P<0.05)。49例患者的主要毒副反应为1～2级骨髓抑制和胃肠道反应,无1例需降低剂量强度或出现化疗相关性死亡。结论国产培美曲塞联合卡铂化疗方案的临床获益显著且安全性高,是一线治疗老年Ⅳ期肺腺癌患者的较好选择。
Objective To explore the efficacy and safety of domestic pemetrexed combined with carboplatin as the first-line treatment in elderly patients with advanced lung adenocareinoma. Methods From July 2009 to December 2011, clinical data of 49 elderly（ ≥65 years） patients with 1V stage lung adenocarcinoma were analyzed retrospectively. Forty-nine patients received domestic pemetrexed 500mg/m^2 iv, d1 and carboplatin （AUC = 5 ） iv, d1. Every 3 weeks was a cycle. The recent efficacy was evaluated every 2 cycles and long-term efficacy was followed up. The relevant indexes were analyzed. The side-effects were recorded each cycle. Results Among 49 patients, 48 patients were treated with pemetrexed combined carboplatin at least 2 cycles. The response rate and disease control rate of the 48 patients were 22. 9% and 64. 6% , respectively. The median progression-free survival（PFS） was 6. 5 months （95% C1：5. 7-7. 3 ）, and median overall survival（OS） was 11.3 months （95% CI ： 10. 6-11.9）. According to age, sex, ECOG score, smoking, metastasis numbers, bone metastasis, malignant pleural effusion and brain metastasis, patients were divided into groups. There were significant differences in RR, PFS or OS between groups of ECOG score, smoking and metastasis numbers（ P 〈 0. 05 ）. The major side-effects were bone marrow suppression and gastrointestinal toxicity. The adverse events were manageable at grade 1-2. Con- clusion Domestic pemetrexed in combination with carboplatin is effective and well tolerated as the first-line treatment in elderly pa- tients with advanced lung adenocarcinoma.
出处
《临床肿瘤学杂志》
CAS
2013年第3期233-237,共5页
Chinese Clinical Oncology
关键词
肺腺癌
老年
培美曲塞
卡铂
化学治疗
Lung adenocarcinoma
Elderly
Pemetrexed
Carboplatin
Chemotherapy
