一线单药培美曲塞治疗老年晚期肺腺癌患者疗效观察

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目的观察培美曲塞单药化疗一线治疗老年晚期肺腺癌患的疗效及不良反应。方法 85例经病理确诊的老年晚期肺腺癌患者随机分为培美曲塞组及单药多烯紫彬醇组,每周期评价不良反应、生活质量,每2周期评价疗效。结果培美曲塞组及多烯紫彬醇组有效率(ORR)为13.9%及14.2%,疾病控制率(DCR)为55.7%及52.3%。培美曲塞组中位无进展生存期(PFS)3.5月(95%CI 2.2~4.6月)、中位总生存期(OS):6.9月(95%CI 3.2~7.2月)。多烯紫彬醇组中位PFS3.4月(95%CI 1.9~4.3月)、中位OS:6.2月(95%CI 3.9~7.7月)。无统计学差异(P>0.05)。血液毒性培美曲塞组3度以上粒细胞减少发生率(4.6%)和3度以上血小板减少发生率(4.6%)低于多烯紫彬醇组(11.9%和11.9%),统计学分析显有著性差异(P<0.05);非血液毒性乏力及腹泻发生率低于多烯紫彬醇组(P<0.05);生活质量评价培美曲塞组优于多烯紫彬醇组。结论培美曲塞用于国人老年晚期肺腺癌患者一线化疗与多烯紫彬醇疗效相当,不良反应轻,患者有更高的生活质量,值得在临床推广。 Objective To observe the curative effect and adverse reactions of pemetrexed monotherapy in the treatment of senile advanced lung adenocarcinoma. Methods Eighty-five elderly patients with advanced lung adenocarcinoma diagnosed by pathology were randomly divided into pemetrexed group and single-drug combination group. The adverse reaction, quality of life and quality of life were evaluated every two weeks. Results The response rates of pemetrexed group and docetaxel group were 13.9% and 14.2%, and the disease control rates (DCRs) were 55.7% and 52.3% respectively. The median progression-free survival (PFS) was 3.5 months (95% CI, 2.2 to 4.6 months) in the pemetrexed group, and the median overall survival (OS) was 6.9% (95% CI 3.2-7.2 months). Median PFS3.4 months (95% CI 1.9-9.3 months), median OS: 6.2 months (95% CI 3.9-7.7 months). No statistical difference (P> 0.05). Hematotoxicity Pegasys above 3 degrees in the group of neutropenia (4.6%) and 3 degrees above the incidence of thrombocytopenia (4.6%) was lower than the docetaxel group (11.9% and 11.9%), statistical analysis (P <0.05). The incidence of non-hematologic toxicity and diarrhea was lower than that of the docetaxel group (P <0.05). The quality of life evaluation of the pemetrexed group was superior to that of the docetaxel group. Conclusion Pemetrexed for first-line chemotherapy in elderly patients with advanced lung adenocarcinoma of the country with the same efficacy of polyenic violet alcohol, mild adverse reactions, patients with higher quality of life, it is worth in the clinical promotion.
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