培美曲塞联合顺铂治疗晚期非小细胞肺癌45例近期疗效观察.doc

培美曲塞联合顺铂治疗晚期非小细胞肺癌45例近期疗效观察[摘要] 目的 对培美曲塞联合顺铂治疗晚期非小细胞肺癌(NSCLC)进行临床疗效和毒性评价。方法 45例经病理组织学和/或细胞学检查确诊NSCLC,均为初治患者,其中男性28例,女性17例;年龄31~76岁,中位年龄58岁,鳞癌12例,腺癌30例,腺鳞癌3例,TNM分期:ⅢA7例,ⅢB16例,Ⅳ22例,应用培美曲塞联合顺铂治疗,即培美曲塞500mg/m2,顺铂75mg/m2,21d为一周期,至少接受2个周期化疗。按照WHO标准评价临床疗效和毒性。结果 45例患者中,无完全缓解(CR)病例,部分缓解(PR)10例,稳定(SD)13例,进展(PD)22例,有效率(CR+PR)22.22%,临床获益率(CR+PR+SD)51.11%,主要毒性反应为骨髓抑制,胃肠道反应。结论 培美曲塞联合顺铂治疗晚期NSCLC疗效可靠,毒性反应小,与国内外文献报道的缓解率及有效率类似。 [关键词] 培美曲塞;顺铂;晚期非小细胞肺癌;化疗 [中图分类号] R734.2 [文献标识码] A [文章编号] 1673-9701(2009)36-54-03 Pemetrexed Combined with Oxaliplatin in Treatment of Advanced Non-small Cell Lung Cancer:A Clinical Observation of 45 Cases BI Shuting Department of Respiratory,Nanjing Municipal Chest Hospital,Nanjing 210029,China [Abstract]Objective To observe the clinical efficacy and adverse effects of pemetrexed combined with oxaliplatin to treat advanced non-small cell lung cancer. Methods Forty-five cases aged 31~76 years(a median age of 58 years)were newly diagnosed as advanced non-small cell lung cancer by histopathological and/or cytology,28 cases were male and 17 female,and in 45 cases,12 cases were squamous cell carcinoma,30 were adenocarcinoma and 3 were adenosquamous carcinoma. TNM staging showed 7 cases of ⅢA,16 cases of Ⅲ B and 22cases of Ⅳ. Pemetrexed 500mg/m2 and cisplatin 75mg/m2 were used for at least 2 cycles of chemotherapy with 21 days as a cycle. Based on WHO criteria,the clinical efficacy and toxicity were evaluated. Results In 45 patients,there were no cases of complete remission(CR),10 cases of partial remission(PR)13 cases of stablility(SD)and 22 cases of progress(PD). The effective rate(CR+PR)was 22.22% and the clinical benefit rate(CR+PR+SD) was 51.11%,and the main side effects were myelosuppression and gastrointestinal tract reaction. Conclusion The combination of pemetrexed and oxaliplatin in the treatment of advanced non-small cell lung cancer has reliable efficacy and fewer side effects,showing similar remission rate and effective rate reported