摘要
目的探讨培美曲塞或依托泊苷联合同步放化疗治疗局部晚期老年肺腺癌的近期疗效以及急性不良反应。方法方法对经病理证实为IIIA或IIIB期的60例老年肺腺癌患者根据治疗方法分为实验组、对照组，实验组使用培美曲塞[500mg／（m^2·d）]，共2个周期；对照组使用依托泊苷Doomg／d，d1—d5]，共2个周期。化疗同时给予三维适形放疗（3DCRT），处方剂量为60Gy，6周完成。结果有效率（CR＋PR）实验组为80．0％（24／30），对照组为73．3％（22／30），2组差异无统计学意义（P〉0．05），实验组1年和2年生存率分别为76．7％和56．7％，对照组为73．3％和52．3％，两组无明显差异（P〉0．05）；不良反应主要包括恶心呕吐、骨髓抑制、肺毒性、食管毒性，其中对照组比实验组组更容易发生中性粒细胞减少，差异有统计学意义（P〈0．05）。结论培荧曲塞或依托泊苷联合同步放疗治疗局部晚期老年腺癌近期疗效良好，培美曲塞的不良反应更低，值得临床使用，但从经济学考虑依托泊苷也值得临床推广应用。
Objective To sttldy the short-term effects and toxicities of pemetrexed or etoposide combined with concurrent chemoradiotherapy for elderly patients with locally advanced lung adenocarcinoma. Methods 60 elderly patients who were histologically confirmed to be stage ⅢA or ⅢB lung adenocarcinoma were divided into the treatment group and the control group,each with 30 cases. The treatment group was given pemetrexed 500 mg/（m2·d） for 2 cycles. The control group was given etoposide（100 mg/d, d1-d5 ） for 2 cycles. Both groups received three dimensional conformal radiation therapy （3DCRT） at the same time,the prescrip-tion dose was 60 Gy for 6weeks. Results The overall response rates （CR＋PR） ot the treatment group ana me COiltiOl group welt 80.0%（24/30） and 73.3%（ 22/30） ,the 1 and 2years survival rates were 76.7% ,56.70% ,and 73.3% ,53.3% （P〉0.05） ,respectively. There was no statistical difference between the 2 groups（P〉0.05）, The main adverse reactions were nausea, vomiting, neu-tropenia thrombocytopenia,anemia, radiation induced-pneumonitis and radiation induced-esophagitis. The incidence of neutrophilic granulc, cytopenia of the treatment group was higher than of the control group. There was significant difference between the 2groups （P〈0.05）. Conelusion Pemetrexed or etoposide conbined with concurrent chemoradiotherapy for elderly patients with locally advanced lung adenocarcinoma have good short-term curative effects and pemetrexed for chemotherapy has fewer complications,etopo-side is reasonable and elective therapy. They are worthy of clinical application.
出处
《检验医学与临床》
CAS
2016年第A02期145-148,共4页
Laboratory Medicine and Clinic
关键词
肺腺癌
培美曲塞
依托泊苷
放疗
Lung Cancer
Pemetrexed
Etoposide
Radiotherapy
