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目的:观察培美曲塞一线治疗老年晚期非小细胞肺癌的临床疗效及不良反应。方法:经组织病理或细胞学检查确诊老年晚期非小细胞肺癌患者34例,均给予培美曲塞600 mg/m2,静脉滴注,第1天,21 d为1周期。治疗2个周期评定疗效和不良反应,并随访观察生存时间、肿瘤进展时间。结果:34例患者共完成138个周期治疗,化疗周期2~8次,无因药物不良发应停药病例。治疗2个周期后,部分缓解9例,无变化8例,无效17例,有效率26.5%,疾病控制率50.0%。1 a生存率41.2%(14/34),2 a生存率20.6%(7/34);肿瘤进展时间2~16个月,中位肿瘤进展时间3.4个月;生存期5~29个月,中位生存期8.9个月。治疗过程中发生Ⅰ~Ⅲ度乏力19例,Ⅰ~Ⅱ度白细胞下降16例;口腔黏膜炎、皮疹、消化道反应及肝、肾功能损害少见。结论:培美曲塞一线治疗老年晚期非小细胞肺癌疗效满意,不良反应轻,耐受性好。
Objective: To observe the clinical efficacy and adverse reactions of pemetrexed in the treatment of senile advanced non-small cell lung cancer. METHODS: Thirty-four patients with advanced NSCLC diagnosed by histopathology or cytology were given pemetrexed 600 mg / m2 intravenously. On day 1 and day 21, they were given one cycle. The curative effect and adverse reactions were evaluated after 2 cycles of treatment, and the survival time and tumor progression time were observed. Results: A total of 138 cycles were completed in 34 patients. Chemotherapy cycles were performed 2 to 8 times without any discontinuation due to adverse drug reactions. After 2 cycles of treatment, partial remission in 9 cases, no change in 8 cases, ineffective in 17 cases, effective rate 26.5%, disease control rate 50.0%. 1 year survival rate was 41.2% (14/34), 2 year survival rate was 20.6% (7/34); tumor progression time was 2 to 16 months, median tumor progression time was 3.4 months; survival time was 5 to 29 months, Median survival of 8.9 months. In the course of treatment, 19 cases of grade Ⅰ ~ Ⅲ degree weakness and 16 cases of grade Ⅰ ~ Ⅱ grade leukopenia occurred. Oral mucositis, rash, gastrointestinal reactions and liver and renal dysfunction were rare. Conclusion: Pemetrexed first-line treatment of elderly patients with advanced non-small cell lung cancer is satisfactory, with mild adverse reactions and good tolerability.