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目的观察培美曲塞(Pemetrexed,PEM)联合奈达铂(Nedaplatin,NDP)方案二线治疗晚期非小细胞肺癌(NSCLC)的临床疗效及不良反应。方法自2003年1月～2007年8月间,收集在我院肿瘤科经4～6个周期的一线化疗后复发或转移的晚期NSCLC患者36例,给予PEM500mg/m2,静注,第1d,NDP100mg/m2,静注,第2d;21d为1疗程,两个周期化疗后评价临床疗效及不良反应,随访一年。结果入组的36例患者均可评价疗效,其中部分缓解(PR)5例,稳定(SD)14例,进展(PD)17例,有效(RR)为13.89%,稳定率为52.78%,中位生存期为10.2个月,1年存活率36.11%。主要的不良反应是骨髓抑制,白细胞下降达Ⅲ、IV度者为10例(27.78%),血小板下降达Ⅲ、IV度者5例(13.89%),血红蛋白下降达Ⅲ、IV度者4例(11.11%),胃肠道反应如恶心、呕吐占3例(8.33%),脱发、皮疹、腹泻等发生率均较低。结论培美曲塞联合奈达铂二线治疗晚期非小细胞肺癌疗效确切,且不良反应可以耐受。
Objective To observe the clinical efficacy and side effects of Pemetrexed (PEM) plus Nedaplatin (NDP) in the second-line treatment of advanced non-small cell lung cancer (NSCLC). Methods From January 2003 to August 2007, 36 patients with advanced NSCLC who recurred or metastasized after first to fourth cycles of oncology in our hospital from April 2006 to August 2007 were enrolled in this study. PEM 500 mg / m 2, intravenous injection, NDP100mg / m2, intravenous injection, 2d; 21d for a course of treatment, two cycles of chemotherapy to evaluate the clinical efficacy and adverse reactions, followed up for one year. Results Among the 36 patients enrolled in the study, there were 5 cases of partial remission (PR), 14 cases of stable (SD) and 17 cases of progressive (PD). The effective rate (RR) was 13.89% and the stability rate was 52.78% The median survival time was 10.2 months and the one-year survival rate was 36.11%. The main adverse reactions were myelosuppression, leukopenia in Ⅲ, IV in 10 (27.78%), platelet in Ⅲ, IV in 5 (13.89%), hemoglobin in Ⅲ, and IV in 4 11.11%), gastrointestinal reactions such as nausea and vomiting accounted for 3 cases (8.33%), hair loss, skin rashes, diarrhea, etc. were lower. Conclusion Pemetrexed combined with nedaplatin second-line treatment of advanced non-small cell lung cancer is effective, and adverse reactions can be tolerated.