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目的观察培美曲塞治疗50例晚期非小细胞肺癌(NSCLC)患者的疗效和毒副反应。方法收集2006年6月至2010年4月接受培美曲塞化疗的50例NSCLC患者,分为单药组13例和联合组37例。单药组:培美曲塞500mg/m2d1,q3w。联合组:培美曲塞500mg/m2d1,卡铂(AUC=5)d1,或顺铂25mg/m2d1~d3,或奈达铂80mg/m2d1,q3w。所有患者接受至少2个周期化疗。近期疗效评价采用RECIST1.0标准,毒副反应评价按照WHO毒性评定标准。生活质量评价参照孙燕提出的生活质量(QOL)评分表。结果 50例患者均可评价疗效,完全缓解(CR)2例,部分缓解(PR)7例,稳定(SD)22例,进展(PD)19例,有效率(RR)18.0%,疾病控制率(DCR)62.0%。生活质量改善率达58.0%。主要毒性反应为1~2级骨髓抑制和胃肠道反应,经对症处理后不影响化疗进行。结论以培美曲塞为主的化疗方案治疗晚期NSCLC疗效较好,可明显改善患者生活质量,且毒性反应轻,易于耐受。
Objective To observe the efficacy and toxicity of pemetrexed in the treatment of 50 patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 50 patients with NSCLC who received pemetrexed chemotherapy from June 2006 to April 2010 were collected and divided into a single-agent group and a combined group of 13 patients. Single drug group: Pemetrexed 500mg/m2d1, q3w. Combined group: Pemetrexed 500mg/m2d1, carboplatin (AUC=5)d1, or cisplatin 25mg/m2d1~d3, or nedaplatin 80mg/m2d1, q3w. All patients received at least 2 cycles of chemotherapy. The short-term efficacy evaluation uses the RECIST 1.0 standard, and toxic side effects are evaluated according to the WHO toxicity evaluation standard. The quality of life evaluation is based on Sun Yan’s quality of life (QOL) score sheet. Results The efficacy was evaluated in 50 patients with complete remission (CR) 2 cases, partial remission (PR) 7 cases, stable (SD) 22 cases, progress (PD) 19 cases, effective rate (RR) 18.0%, disease control rate (DCR) 62.0%. The quality of life improvement rate reached 58.0%. The main toxicities were Grade 1~2 myelosuppression and gastrointestinal reactions, which did not affect chemotherapy after symptomatic treatment. Conclusion The treatment of advanced NSCLC with pemetrexed-based chemotherapy is effective and can significantly improve the quality of life of patients. The toxicity is light and easy to tolerate.