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目的探讨重组人血管内皮抑素(恩度)联合培美曲塞和卡铂(PC)方案一线治疗年龄大于70岁的晚期肺腺癌患者的疗效和不良反应。方法回顾性分析41例经病理组织学证实的高龄肺腺癌患者,给予重组人血管内皮抑素(恩度)联合培美曲塞和卡铂(PC)方案化疗。恩度15mg/d静滴,第1～14天;培美曲塞500mg/m2,第1天;卡铂取AUC为5,第1天,21天为1个周期,记录治疗的有效率(RR)、无疾病进展生存时间(PFS)、总生存期(OS)和不良反应。按实体瘤疗效评价标准评价治疗效果。结果 41例均可评价疗效,完全缓解(CR)2例,部分缓解(PR)13例,稳定(SD)15例,进展(PD)11例。有效率(CR+PR)为36.6%,疾病控制率(CR+PR+SD)为73.2%,中位PFS为7.9个月,中位OS为13个月。主要不良反应为Ⅰ～Ⅱ级的胃肠道反应和骨髓抑制,Ⅲ～Ⅳ级不良反应包括中性粒细胞缺乏4例,无化疗相关性死亡。结论重组人血管内皮抑素联合PC方案一线治疗高龄晚期肺腺癌患者疗效较好,不良反应可以耐受。
Objective To investigate the efficacy and adverse reactions of recombinant human endostatin (Endostar) combined with pemetrexed and carboplatin (PC) in the first-line treatment of patients with advanced lung adenocarcinoma older than 70 years. Methods A retrospective analysis of 41 cases of pathologically confirmed advanced lung adenocarcinoma patients were given recombinant human endostatin (Endostar) combined pemetrexed and carboplatin (PC) regimen chemotherapy. Endostar 15mg / d intravenous infusion, the first to 14 days; pemetrexed 500mg / m2, the first day; take carboplatin AUC of 5, the first day, 21 days for a cycle, record the effectiveness of treatment RR), disease-free survival time (PFS), overall survival (OS) and adverse reactions. According to solid tumor efficacy evaluation criteria to evaluate the treatment effect. Results All the 41 cases were evaluated for efficacy, complete remission (CR) in 2 cases, partial remission (PR) in 13 cases, stable (SD) in 15 cases and progression (PD) in 11 cases. The effective rate (CR + PR) was 36.6%, disease control rate (CR + PR + SD) was 73.2%, median PFS was 7.9 months, and median OS was 13 months. The main adverse reactions were grade Ⅰ-Ⅱ gastrointestinal reactions and myelosuppression. Grade Ⅲ-Ⅳ adverse reactions included 4 cases of neutropenia and no chemotherapy-related death. Conclusions The first-line treatment of advanced human endostatin combined with PC regimen has better efficacy in patients with advanced advanced lung adenocarcinoma, and the adverse reactions can be tolerated.