叶晓贤, 袁瑛, 沈虹. 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[J]. 中国肿瘤临床, 2013, 40(21): 1324-1327. DOI: 10.3969/j.issn.1000-8179.20130400
引用本文: 叶晓贤, 袁瑛, 沈虹. 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[J]. 中国肿瘤临床, 2013, 40(21): 1324-1327. DOI: 10.3969/j.issn.1000-8179.20130400
Xiaoxian YE, Ying YUAN, Hong SHEN. Pemetrexed and platinum as first-line chemotherapy for advanced lung adenocarcinoma: an observation of recent therapeutic effects and a safety profile[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1324-1327. DOI: 10.3969/j.issn.1000-8179.20130400
Citation: Xiaoxian YE, Ying YUAN, Hong SHEN. Pemetrexed and platinum as first-line chemotherapy for advanced lung adenocarcinoma: an observation of recent therapeutic effects and a safety profile[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(21): 1324-1327. DOI: 10.3969/j.issn.1000-8179.20130400

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

Pemetrexed and platinum as first-line chemotherapy for advanced lung adenocarcinoma: an observation of recent therapeutic effects and a safety profile

  • 摘要:
      目的  观察培美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41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,PR 17例,SD 20例,PD 4例。总的客观有效率(ORR)为41.5%,疾病控制率(DCR)90.3%。其中男性患者有效率显著高于女性患者(63.1% vs. 22.7%,P=0.009)。所有患者的中位PFS为11.0个月,中位OS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。

     

    Abstract:
      Objective  The recent therapeutic effects and safety profile of pemetrexed plus cisplatin as first-line chemotherapy in advanced lung adenocarcinoma were evaluated.
      Methods  A total of 41 chemotherapy-naive locally advanced or metastatic non-small cell lung cancer patients, who were diagnosed with adenocarcinoma by pathological examination, were included. All patients received 500 mg/m2 pemetrexed on day 1. A total dose of 75 mg/m2 cisplatin was divided into three daily doses administered over 3 d. Treatments were repeated every three weeks. The therapeutic efficiency and safety profile were evaluated every two treatment cycles.
      Results  All 41 patients were eligible for the evaluation of therapeutic efficiency. Seventeen patients showed partial response, 20 patients showed stable disease, and four patients showed disease progression. The overall response rate (ORR) was 41.5% and the disease control rate (DCR) was 90.3%. Subgroup analysis showed that the ORR in males was significantly higher than that in females (63.1% vs. 22.7%, P=0.009). The median progression-free survival of all patients was 11.0 months, whereas the median overall survival was 12.6 months. The intracranial lesions of six patients with brain metastases were well controlled after chemotherapy and palliative whole brain radiotherapy. The ORR and DCR for these patients were 83.3% and 100.0%, respectively. In terms of safety, only 4.8% of the patients showed grades Ⅲ and Ⅳ neutropenia, nausea, or vomiting.
      Conclusion  Pemetrexed plus cisplatin is an effective and well-tolerated regimen as first-line therapy for patients with lung adenocarcinoma. According to subgroup analysis, efficacy in males was significantly better than that in females. Good efficacy was observed in patients with brain metastases treated with chemotherapy and palliative whole brain radiotherapy. No additional adverse effects were observed.

     

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