论文部分内容阅读
目的观察培美曲塞联合奥沙利铂二线化疗治疗紫杉类药物(多西他赛、卡巴他赛)治疗后进展的去势抵抗性前列腺癌(Metastatic Castrate-Resistant Prostate Cancer,mCRPC)的疗效和安全性。方法 18例在多西他赛或卡巴他赛加泼尼松治疗过程中或治疗结束后疾病进展的mCRPC患者,用培美曲塞联合奥沙利铂方案二线治疗:第1天用培美曲塞500mg/m~2,奥沙利铂100mg/m~2,21d为1周期。主要观察终点是PSA,PSA下降>50%且维持超过1个周期为有效;次要观察终点包括可测量病灶有效率及毒副作用。结果患者接受中位5(范围:1~11)个周期培美曲塞联合奥沙利铂方案化疗,18例患者共完成85个周期治疗。可评价疗效13例,PSA有效7例,有效率53.8%,其中1例可测量病灶达部分缓解。18例均可评价毒副作用,Ⅲ-Ⅳ度毒副作用包括腹泻1例(5.6%),乏力1例,中性粒细胞减少1例,贫血1例。2例因毒副作用退出治疗。结论对于多西他赛或卡巴他赛加泼尼松方案治疗后进展的mCRPC患者,用培美曲塞联合奥沙利铂二线治疗疗效较好,毒副反应可以耐受,值得进一步观察研究。
Objective To observe the curative effect of pemetrexed plus oxaliplatin second-line chemotherapy on Metastatic Castrate-Resistant Prostate Cancer (mCRPC) following the treatment of taxanes (docetaxel and cabazitaxel) And safety. Methods Eighteen patients with mCRPC who were treated with docetaxel or oxaliplatin during or after docetaxel or cabazitaxel plus prednisone were treated with pemetrexed plus oxaliplatin regimen: Day 1 with pemetrexed Plug 500mg / m ~ 2, oxaliplatin 100mg / m ~ 2, 21d for a cycle. The primary endpoints were PSA, PSA reduction> 50% and maintenance of more than 1 cycle was valid; secondary endpoints included measurable lesion efficiency and toxic side effects. Results Patients received median 5 (range: 1-11) cycles of pemetrexed plus oxaliplatin regimen, and 18 patients completed 85 cycles. Evaluable efficacy in 13 cases, PSA effective in 7 cases, the effective rate was 53.8%, of which 1 case of measurable lesions up to partial remission. Toxicities and side effects were evaluated in 18 cases. Grade Ⅲ-Ⅳ toxicities included 1 case of diarrhea (5.6%), 1 case of weakness, 1 case of neutropenia and 1 case of anemia. 2 patients quit treatment due to toxic side effects. Conclusions For patients with mCRPC who progress after the docetaxel or cabazitaxel plus prednisone regimen, pemetrexed combined with oxaliplatin second-line therapy is effective and toxic side effects are tolerable and warrants further investigation.