CAJ | 학술논문

目的：观察培美曲塞联合卡铂治疗老年晚期非鳞型非小细胞肺癌（ NSCLC）的疗效和毒副反应。方法收集45例经病理组织学或细胞学确诊的老年晚期非鳞型NSCLC患者，接受培美曲塞联合卡铂方案化疗，21 d为1周期，至少治疗2周期，观察疗效和毒副反应。结果所有患者均完成3~6周期化疗，可评价疗效。有效率为26.7%，疾病控制率为73.3%，临床受益有效率为75.8%；中位疾病无进展时间为6.8个月，1 a生存率为62.2%。ECOG评分0~1分者较2分者的疾病控制率高（ P<0.05）；临床分期Ⅲb期者较Ⅳ期者的疾病控制率高（ P<0.05）。毒副反应主要为骨髓抑制、胃肠道反应、周围神经毒性，多为Ⅰ、Ⅱ度，患者可以耐受，经对症处理，不影响继续化疗。结论培美曲塞联合卡铂方案治疗老年晚期非鳞型NSCLC的疗效确切，毒副反应轻，患者耐受性较好，值得临床进一步研究推广。
목적：관찰배미곡새연합잡박치료노년만기비린형비소세포폐암（ NSCLC）적료효화독부반응。방법수집45례경병리조직학혹세포학학진적노년만기비린형NSCLC환자，접수배미곡새연합잡박방안화료，21 d위1주기，지소치료2주기，관찰료효화독부반응。결과소유환자균완성3~6주기화료，가평개료효。유효솔위26.7%，질병공제솔위73.3%，림상수익유효솔위75.8%；중위질병무진전시간위6.8개월，1 a생존솔위62.2%。ECOG평분0~1분자교2분자적질병공제솔고（ P<0.05）；림상분기Ⅲb기자교Ⅳ기자적질병공제솔고（ P<0.05）。독부반응주요위골수억제、위장도반응、주위신경독성，다위Ⅰ、Ⅱ도，환자가이내수，경대증처리，불영향계속화료。결론배미곡새연합잡박방안치료노년만기비린형NSCLC적료효학절，독부반응경，환자내수성교호，치득림상진일보연구추엄。
Objective To evaluate the efficacy and toxicities of pemetrexed combined with carboplatin in the treatment of elderly patients with advanced non-squamous non-small cell lung cancer( NSCLC). Methods Forty-five elderly patients with advanced non-squamous NSCLC confirmed with pathology or cytology were received peme-trexed and carboplatin with 21 days as a cycle. Each patient received at least 2 cycles. The efficacy and toxicities were observed. Results The efficacy of the 45 patients could be evaluated. The response rate was 26. 7%,the dis-ease control rate was 73. 3%,the clinical benefit rate was 75. 6%,the median progression free survival was 6. 8 months,and the median 1-year survival rate were 62. 2%. The disease control rate of patients with ECOG 0-1 was higher than that of patients with ECOG 2(P<0. 05);The disease control rate of patients with clinical stageⅢb was intestinal reaction and peripheral neurotoxicity. Conclusion Pemetrexed combined with carboplatin is effective and tolerable in the treatment of elderly patients with advanced non-squamous NSCLC.