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目的:观察培美曲塞单药或联合铂类治疗晚期肺腺癌的临床疗效、临床受益率和毒性反应。方法:单药方案为培美曲塞(500mg/m2)d1静滴;联用方案为培美曲塞(500mg/m2)d1静滴,卡铂(AUC=5)或顺铂(75mg/m2)分d(1～2)静滴。应用培美曲塞24小时前口服地塞米松4mg,2次/天,连服3天;应用培美曲塞前1周口服叶酸400μg,1次/天,连服直到培美曲塞结束后21天;应用培美曲塞前1周予VitB121 000μg肌注,每9周1次。疗效按照WHO统一评价标准评定,毒性反应按照WHO抗癌药物毒性标准评定。结果:全组13例可评价疗效者12例,1例只进行单药一周期治疗无法评价。其中CR 2例,PR 1例,SD 5例,PD 4例。缓解率25.0%,临床获益率66.7%。毒性反应均为Ⅰ度、Ⅱ度的骨髓抑制和胃肠道反应。结论:单药或联合使用培美曲塞治疗晚期肺腺癌有较好疗效,毒性反应轻,耐受性好。
Objective: To observe the clinical efficacy, clinical benefit rate and toxicity of pemetrexed monotherapy or platinum in the treatment of advanced lung adenocarcinoma. Methods: The single drug regimen was pemetrexed (500mg / m2) d1 intravenously. The combined regimen was pemetrexed (500mg / m2) d1 intravenous infusion, carboplatin (AUC = 5) or cisplatin ) Points d (1 ~ 2) intravenous infusion. Pemetrexed 24 hours before oral administration of dexamethasone 4mg, 2 times / day, and even for 3 days; pemetrexed oral folic acid 400μg 1 week before oral administration, once a day, and even served until the end of pemetrexed 21 days; Pemetrexed 1 week prior to VitB121 000μg intramuscular injection, once every 9 weeks. Efficacy in accordance with the WHO uniform evaluation criteria assessment, toxicity according to WHO anti-cancer drug toxicity standards assessment. Results: In the whole group of 13 cases, 12 cases were evaluable and only 1 case was treated with one cycle of monotherapy. Among them CR 2 cases, PR 1 cases, SD 5 cases, PD 4 cases. The remission rate was 25.0%, and the clinical benefit rate was 66.7%. Toxicity were degree Ⅰ, Ⅱ degrees of bone marrow suppression and gastrointestinal reactions. Conclusion: Pemetrexed combined with pemetrexed has better curative effect on advanced lung adenocarcinoma, light toxicity and good tolerance.