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《China Oncology》 2009-02
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Pemetrexed alone or combination regimen for the treatment of advanced chemo-recurrent non-small cell lung cancer:analysis of 68 cases

ZHANG Xue-yan,HUANG Ai-mi,BAI Hao,CHEN Yu-rong,HAN Bao-hui(Department of pulmonary Medicine,Shanghai Chest Hospital affiliated to Shanghai Jiao Tong University,Shanghai 200030,China)  
Background and purpose:The effective rate of first-line chemotherapy for advanced lung cancer is 30%-40%.Treatment of advanced chemo-recurrent patients needs new drugs and treatment methods.Pemetrexed(alimta) as a multi-target antifolate chemotherapeutic drug,was approved for the second-line treatment of advanced non-small cell lung cancer(NSCLC) in August 2004.The purpose of this study was to evaluate the efficacy and side effects of pemetrexed alone or pemetrexed combined with cisplatin/carboplatin in the treatment of advanced recurrent(NSCLC).Methods:Sixty-eight patients with advanced NSCLC who had failed to previous chemotherapy were enrolled in this study and all of these patients had been confirmed with pathology or cytology.Among the 68 cases,45 cases were male and 23 were female,the median age was 58 years,Single agent regimen:patients received pemetrexed 500 mg/m2 on day 1,by intravenous infusion,with every 21 days.Combination regimen:patients received pemetrexed 500 mg/m2 on day 1 and cisplatin 60 mg/m2 or carboplatin 300 mg/m2 on day 2 by intravenous infusion,with 21 days as one cycle.All patients who received 2 or more cycles could be evaluated.Results:There was no case with complete response.2 cases had partial response,41 had stable disease and 25 cases had progressive disease.The disease control rate was 63%(43/68).The median survival time was 2.9 months and of which 2.3 months in squamous cell carcinoma;adenocarcinoma,3.2 months;3.1 months on the others,respectively.There was significant difference between squamous cell carcinoma and non-squamous cell carcinoma.The common adverse effects were leucopenia,anemia and gastrointestinal response.Conclusion:Pemetrexed or pemetrexed combined with cisplatin/carboplatin is effective and feasible for advanced recurrent NSCLC.Pemetrexed is one of the choices for NSCLC patients who failed first line chemotherapy therapy.
【CateGory Index】: R734.2
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