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目的观察培美曲塞二钠二线治疗32例晚期肺腺癌患者的近期疗效及不良反应。方法 32例经病理学确诊既往化疗失败的进展期肺腺癌患者,其中男性19例,女性13例,中位年龄61岁。单药组:培美曲塞500 mg/m2,第1天静脉滴注;联合组:培美曲塞500 mg/m2第1天+顺铂20 mg/m2第1～4天,均为每3周重复,并口服地塞米松、叶酸和肌肉内注射维生素B12以减轻毒副反应。完成2个周期及以上评价疗效和不良反应。结果 32例患者中,完全缓解0例,部分缓解4例,客观有效率12.5%,稳定18例,进展10例,疾病控制率68.8%,疾病进展时间3.1个月。主要不良反应为骨髓抑制和胃肠道反应。结论培美曲塞二钠作为二线治疗化疗失败的晚期肺腺癌,具有较好的疗效和安全性。
Objective To observe the short-term curative effect and adverse reaction of pemetrexed disodium second-line therapy in 32 patients with advanced lung adenocarcinoma. Methods Thirty-two patients with advanced lung adenocarcinoma, who had been previously diagnosed as pathologically unsuccessful, including 19 males and 13 females, were selected. The median age was 61 years. Monotherapy group: pemetrexed 500 mg / m2, intravenous drip on day 1; combination group: pemetrexed 500 mg / m2 on day 1 + cisplatin 20 mg / m2 on days 1 to 4, 3 weeks repeated, and oral dexamethasone, folic acid and intramuscular injection of vitamin B12 to reduce side effects. Complete 2 cycles and above evaluation of efficacy and adverse reactions. Results Among the 32 patients, 0 was completely relieved, 4 were partly relieved, objective response rate was 12.5%, 18 were stable, 10 were progressed, disease control rate was 68.8% and disease progression time was 3.1 months. The main adverse reactions were myelosuppression and gastrointestinal reactions. Conclusion Pemetrexed disodium, as a second-line chemotherapy for advanced lung adenocarcinoma failed, has good curative effect and safety.