培美曲塞二线治疗晚期肺大细胞癌的疗效和安全性分析

比较培美曲塞维持治疗与二线治疗晚期非小细胞肺癌的临床疗效目的：评价晚期非小细胞肺癌（NSCLC）诱导化疗获益后二线化疗药物培美曲塞（PEM）应用于早期维持治疗与延迟二线治疗的疗效。

方法：81例晚期NSCLC患者（ⅢB或Ⅳ期）均接受以铂类为基础的一线治疗4～6周期后，病情获得缓解或稳定的患者随机分为早期组（n=58）和延迟组（n=23）。

所有患者均予PEM（500mg/m2，第1天）联合最佳支持治疗，21d为一周期，同时维生素B12、叶酸、地塞米松预防毒副反应。

结果：早期组的中位无进展生存期（PFS）较延迟组显著延长（6.8±0.7个月比2.7±0.5个月，字2=54.878，P ＜0.001），而中位总生存期（OS）较延迟组有所延长（14.7±0.6个月比12.4±0.5个月，字2=3.018，P=0.082），但差异无统计学意义，腺癌患者中位OS较鳞癌患者显著延长（16.5±0.6个月比11.2±0.5个月；字2=14.734，P＜0.001），两组间的药物的安全性与毒性发生率差异无统计学意义。

结论：提早应用二线化疗药物培美曲塞维持治疗明显延长患者的PFS，并且没有增加毒性反应，腺癌患者可获得较好的生存期。

标签：非小细胞肺癌；维持治疗；二线治疗，培美曲塞过去30年我国肺癌发病率上升465%，其中80%以上为非小细胞肺癌（non-small-cell lung cancer，NSCLC）。

但由于缺少有效的早期诊断方法，70%～80%的肺癌患者就诊时已属晚期（Ⅲ、Ⅳ期）[1]，无法对其进行根治性手术切除，其治疗主要是以化疗为主。

然而，对于经过4～6周期的标准一线治疗后取得病灶稳定或缓解的NSCLC患者是否予维持治疗还存在争议[2]。

目前，大量研究表明，应用安全性和耐受性好的化疗或靶向药物，如多西紫杉醇、吉西他滨、培美曲塞、厄洛替尼和吉非替尼等维持治疗能够有效延缓疾病进展。

培美曲塞对化疗及靶向治疗失败的晚期肺腺癌的疗效观察钟成;刘希光【摘要】目的探讨培美曲塞对化疗及靶向治疗失败的晚期肺腺癌的治疗价值.方法随机抽取2012年8月至2014年8月54例晚期肺腺癌患者的临床资料.按照临床治疗方法将患者分为实验组(28例)和对照组(26例).实验组采用培美曲塞单药化疗,对照组患者经常规治疗无效后采取其他化疗方案、支持治疗等措施.观察患者临床疗效、不良反应发生情况、生活质量变化情况.结果实验组近期疗效优于对照组,差异有统计学意义(P<0.05).实验组不良反应发生率低于对照组,差异有统计学意义(P<0.05).实验组患者QOL总评分高于对照组,差异具有统计学意义(P<0.05).结论培美曲塞治疗化疗及靶向治疗失败的晚期肺腺癌,可有效提高临床疗效,降低不良反应发生情况,改善患者生活质量.%Objective To explore the clinical efficacy of pemetrexed for advanced lung adenocarcinoma failed chemo -therapy and targeted therapy .Methods 54 cases of advanced lung adenocarcinoma were divided into the experiment group ( 28 cases) and the controlgroup(26 cases).The experiment group were treated by pemetrexed ,the control group were treated by oth-er methods.The clinical effects,side effects,QOL of the 2 groups were compared.Results The clinical effects of the experiment group was higher than that of the control group(P<0.05);The side effects of the experiment group were lower than that of the control group(P<0.05);The scores of QOL of the experiment group were higher than that of the control group (P<0.05).Con-clusion Pemetrexed for advanced lung adenocarcinoma failed chemotherapy andtargeted therapy can improve clinical efficacy , reduce side effect ,and improve quality of life .【期刊名称】《实用癌症杂志》【年(卷),期】2016(031)004【总页数】3页(P569-571)【关键词】培美曲塞;化疗;靶向治疗;晚期肺腺癌【作者】钟成;刘希光【作者单位】266021 青岛大学医学院附属医院;266021 青岛大学医学院附属医院【正文语种】中文【中图分类】R734.2我国肺癌患者的发病率和死亡率在不断上升，其中，80%的患者为非小细胞肺癌(non-small cell lung cancer，NSCLC)。

培美曲塞与铂类联合应用对晚期非小细胞肺癌疗效及安全性陈倩;潘超【摘要】目的观察培美曲塞与铂类联用对晚期非小细胞肺癌的治疗效果,并分析其安全性.方法回顾性分析2013年8月～2015年8月在浙江省肿瘤医院胸部肿瘤外科接受化疗的晚期非小细胞肺癌患者的临床资料,根据其化疗方式分为顺铂联合紫杉醇化疗组和顺铂联合培美曲塞化疗组.观察2组患者的治疗效果,比较2组患者治疗前后肿瘤标志物水平、生活质量和毒副作用发生率的差异.结果顺铂联合培美曲塞化疗组治疗的有效率为98.2％,明显高于顺铂联合紫杉醇化疗组(82.5％)(P＜0.05);治疗前2组患者肿瘤标志物水平无明显差异,治疗后2组患者各项肿瘤标志物水平较治疗前均降低,且顺铂联合培美曲塞化疗组降低更明显(P＜0.05);2组患者血液系统毒性,消化道毒性、肝、肾功能损害发生率无明显差异;2组患者治疗前生活质量得分无明显差异,治疗后2组患者生活质量均较治疗前改善,且顺铂联合培美曲塞化疗组改善更明显(P＜0.05).结论培美曲塞与铂类联用对晚期非小细胞肺癌有较好的治疗效果,可明显提高患者的生活质量.【期刊名称】《中国生化药物杂志》【年(卷),期】2016(000)007【总页数】4页(P59-61,65)【关键词】培美曲塞;铂类;非小细胞肺癌;生活质量【作者】陈倩;潘超【作者单位】浙江省肿瘤医院胸部肿瘤外科,浙江杭州310022;浙江省肿瘤医院胸部肿瘤外科,浙江杭州310022【正文语种】中文【中图分类】R734.2肺癌是临床上较为常见的呼吸系统恶性肿瘤，在病死率较高的恶性肿瘤中排名前3位。

相关研究显示，我国现阶段每年的肺癌新发病例可达15万以上，且近年来呈现出了一定的上升趋势[1]。

晚期肺癌患者往往失去了手术机会，其中非小细胞肺癌(non-small celll ung cancer，NSCLC)占到了各种完全肺癌患者的25%以上。

通过静脉化疗的方式可以提高完全肺癌患者的临床治疗有效率，抑制病情进展率，并延长中位生存时间[2]。

培美曲塞和吉西他滨分别联合顺铂治疗晚期肺腺癌近期疗效及毒副反应情况观察[摘要] 目的对比培美曲塞联合顺铂、吉西他滨联合顺铂2种治疗方案对晚期肺腺癌的近期疗效及不良反应，以指导临床药物选择。

方法方便20__年10月—20__年10月该院收治的晚期肺腺癌（ⅢB期及Ⅳ期）患者80例，按治疗方案划分为2组：观察组应用培美曲塞联合顺铂治疗；对照组应用吉西他滨联合顺铂治疗。

均化疗2个周期后，评估并对比疗效及毒副反应。

结果观察组总缓解率30.0%、总控制率67.5%，对照组总缓解率27.5%、总控制率70.0%，2组近期疗效差异无统计学意义（P>0.05）；观察组白细胞下降、血小板下降及脱发发生率分别为12.5%、7.5%、10.0%，明显低于对照组42.5%、37.5%、37.5%，差异有统计学意义（P<0.05），2组其它不良反应发生率差异无统计学意义（P>0.05）。

结论培美曲塞联合顺铂治疗晚期肺腺癌可取得与吉西他滨联合顺铂相近的疗效，且其耐受性优于后者，有一定推广价值。

[关键词] 培美曲塞；吉西他滨；顺铂；肺腺癌；晚期肿瘤；化疗[中图分类号] R246.5 [文献标识码] A [文章编号]1674-0742（20__）05（c）-0127-02[Abstract] Objective To compare the short-term curative effect and side and toxic effect of pemetrexed combined with cis-platinum and gemcitabine combined with cis-platinum in treatment of advanced lung adenocarcinoma in order to guide clinical drug selection. Methods 80 cases of patients with advanced lung adenocarcinoma （ⅢB stage and Ⅳ stage）admitted and treated in our hospital from October 20__ to October 20__ were divided into two groups according to different treatment programs， the observation group were treated with pemetrexed combined with cis-platinum， the control group were treated with gemcitabine combined with cis-platinum， and the curative effect and side and toxic effect of the two groups were evaluated and compared after 2 weeks of chemotherapy. Results The total remission rate and total control rate were respectively 30.0% and 67.5% in the observation group and 27.5% and 70.0% in the control group， and the difference in the short-termcurative effect between the two groups had no statistical significance， P>0.05； the incidence rates of leukocyte decrease， platelet decrease and alopecia in the observation group were obviously lower than those in the control group，（12.5%， 7.5%，10.0% vs 42.5%， 37.5%， 37.5%）， and the differences had statistical significance， P<0.05， and the difference in the incidence rate of side and toxic effect between the two groups had no statistical significance， P>0.05. Conclusion The curative effect of pemetrexed combined with cis-platinum in treatment of advanced lung adenocarcinoma is similar to that of gemcitabine combined with cis-platinum， and the tolerance of it is better than that of the latter，which is of a certain promotion value.[Key words] Pemetrexed； Gemcitabine； Cis-platinum； Lung adenocarcinoma； Advanced tumor；Chemotherapy近年肺腺癌发病率呈上升趋势，已成为肺癌4大类型之首[1]，严重威胁现代人生命安全。

《中国癌症杂志》2009年第19卷第2期118CHINA ONCOLOGY 2009 Vol.19 No.2培美曲塞单药或联合化疗治疗晚期复发性非小细胞肺癌68例分析 ［摘要］　背景与目的：晚期肺癌一线化疗有效率仅30 %～40 %。

复发或初治无效患者的治疗, 需引入新的药物及治疗方法。

培美曲塞(alimta)为多靶点抗叶酸化疗药物,于2004年8月被批准用于晚期NSCLC的二线治疗。

本研究探讨培美曲塞单药或联合化疗方案治疗晚期复发性非小细胞肺癌(NSCLC)的疗效以及不良反应。

方法：经病理学或细胞学确诊的复发性晚期NSCLC患者68例,其中男性45例,女性23例,中位年龄58岁。

单药治疗:培美曲塞500 mg/m2,第1天静脉滴注，每3周重复;联合治疗:培美曲塞500 mg/m2第1天+顺铂70 mg/m2第1天静脉滴注，每3周重复;或培美曲塞500 mg/m2第1天+卡铂300 mg/m2第1天静脉滴注，每3周重复。

评价疗效及不良反应。

结果：68例中无完全缓解病例，部分缓解2例,稳定41例, 进展25例,疾病控制率63%(43/68)。

中位无疾病进展时间2.9个月，其中鳞癌2.3个月，腺癌3.2个月，其他3.1个月，非鳞癌优于鳞癌，差异有显著性(P=0.0029)。

主要不良反应为粒细胞下降、贫血和胃肠道反应。

结论：培美曲塞单药或联合方案治疗一线治疗失败的难治型NSCLC疗效确切,对非鳞癌更具有治疗优势。

不良反应发生率低,耐受性较好。

［关键词］　培美曲塞；　复发；　肺肿瘤；　顺铂；　卡铂 中图分类号：R734.2；R730.53 文献标识码：A 文章编号：1007-3639(2009)02-0118-04Pemetrexed 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)Correspondence to：HAN Bao-hui　E-mail：hbaohui@ ［Abstract］ 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.　［Key words］　pemetrexed; recurrence; lung neoplasm; cisplatin; carboplatin通讯作者：韩宝惠　E-mail:hbaohui@《中国癌症杂志》2009年第19卷第2期119 肺癌是一种常见的肺部恶性肿瘤,其死亡率己占癌症死亡率之首。

培美曲塞二钠治疗晚期非小细胞肺癌的效果及毒副作用左扬松;濮娟;沈文沂;王成师【摘要】目的探讨经一线化疗失败的晚期非小细胞肺癌(NSCLC)患者使用培美曲塞二钠单药治疗的近远期效果及毒副作用,为晚期NSCLC患者二线治疗药物选择提供参考.方法共收集84例经一线化疗失败的晚期NSCLC患者,临床分期Ⅲb-Ⅳ期.采用单盲随机数表法将其分为对照组和观察组,两组各42例.其中对照组接受多西他赛单药化疗,剂量75 mg/m2;观察组采用培美曲塞二钠化疗,500 mg/m2,两组均21天/周期.持续4个周期后采用实体瘤评价标准(RECIST)判定疗效,采用美国国家癌症研究院(NCI)制定的毒性评价标准(CTC)评估两组毒性作用情况.结合1年随访统计两组远期生存情况.结果对照组肿瘤治疗有效率(RR)(完全缓解是CR,部分缓解是PR;RR是CR+PR例数占总例数比例)和疾病控制率(DCR)分别为14.29％(6/42)、64.29％(27/42),观察组RR和DCR分别为16.67％(7/42)、69.05％(29/42),两组间差异均无统计学意义(P>0.05).观察组白细胞下降、恶心呕吐、脱发、肝功能损伤发生率均显著低于对照组,差异有统计学意义(χ2=4.421、4.613、4.459、5.126,P均<0.05).对照组和观察组6个月、1年生存率和总生存期(OS)比较,差异均无统计学意义(P均>0.05).结论一线化疗失败的晚期NSCLC患者采用培美曲塞二钠治疗,化疗近远期效果同多西他赛,但毒性作用明显减轻,未出现严重不良反应,安全性良好,可作为晚期NSCLC患者二线治疗药物的优先选择.【期刊名称】《中国临床保健杂志》【年(卷),期】2019(022)004【总页数】4页(P496-499)【关键词】癌,非小细胞肺;培美曲塞;治疗结果;毒性作用【作者】左扬松;濮娟;沈文沂;王成师【作者单位】南京医科大学康达学院附属涟水人民医院呼吸内科,淮安 223400;南京医科大学康达学院附属涟水人民医院呼吸内科,淮安 223400;南京医科大学康达学院附属涟水人民医院呼吸内科,淮安 223400;南京医科大学康达学院附属涟水人民医院呼吸内科,淮安 223400【正文语种】中文非小细胞肺癌(NSCLC)是肺癌的主要类型，占肺癌患者总数的80%～90%；临床确诊的NSCLC患者中有相当大比重已属于中晚期，其预后及生活质量不容乐观[1-2]。

培美曲塞联合奈达铂或顺铂治疗晚期非小细胞肺癌的安全性分析

王万志;袁越;胡立立;张长海;黄重芹;支太禹 【期刊名称】《临床合理用药杂志》 【年(卷),期】2018(11)25 【摘 要】目的分析培美曲塞联合奈达铂或顺铂治疗晚期非小细胞肺癌(NSCLC)的安全性。方法将68例NSCLC患者采用随机数字表法分为试验组和对照组各34例,试验组给予培美曲塞联合奈达铂方案治疗,对照组给予培美曲塞联合顺铂方案治疗。对比观察2组生活质量情况及不良反应。结果治疗前2组躯体功能、角色功能、情绪功能、认知功能、社会功能、整体健康状况及物理症状评分比较差异均无统计学意义(P>0.05)。治疗后试验组躯体功能、角色功能、情绪功能及整体健康生活质量评分均显著高于对照组,物理症状评分显著低于对照组,差异均有统计学意义(P<0.05)。治疗后2组认知功能、社会功能评分比较差异均无统计学意义(P>0.05)。试验组胃肠道反应、肝损害、肾损害发生率均低于对照组,且试验组各不良反应Ⅲ度、Ⅳ度发生率均显著低于对照组,差异均有统计学意义(P<0.05)。2组白细胞减少发生率比较差异无统计学意义(P>0.05)。给予针对性干预后,症状均有所缓解。结论培美曲塞联合奈达铂治疗NSCLC效果较好,可改善生活质量,减少不良反应,具有较高安全性。

【总页数】2页(P72-73) 【作 者】王万志;袁越;胡立立;张长海;黄重芹;支太禹 【作者单位】黔西南布依族苗族自治州人民医院 【正文语种】中 文 【中图分类】R734.2 【相关文献】 1.培美曲塞、吉西他滨联合奈达铂化疗方案治疗晚期非小细胞肺癌的临床疗效及安全性2.培美曲塞联合奈达铂或顺铂治疗晚期肺腺癌的安全性的前瞻性临床研究——不良反应及毒副作用3.培美曲塞联合奈达铂或顺铂治疗晚期肺腺癌的安全性的前瞻性临床研究--不良反应及毒副作用4.培美曲塞+奈达铂联合贝伐珠单抗治疗后行培美曲塞联合贝伐珠单抗维持治疗在晚期非鳞非小细胞肺癌中的疗效与安全性分析5.培美曲塞联合奈达铂或顺铂治疗晚期非小细胞肺癌的临床疗效

培美曲塞联合奥沙利铂治疗晚期非小细胞肺癌的疗效及安全性分析佟菲;宁华;赵杨【摘要】Objective To study the efficacy and safety of pemetrexed combined with oxaliplatin in the treatment of advanced non-small celllung cancer ( NSCLC ) .Methods One hundred and ten NSCLC patients were randomly divided into study group treated with pemetrexed combined with oxaliplatin and control group treated with pemetrexed alone,55 cases in each group .The clinical effect and the incidences of adverse reactions were compared between two groups.Results The effectof study group was better than that of control group (P<0.05).There were no significant differences in the incidences of decreasedhemoglobin ,increased creatinine ,vomiting,rash,allergic reactions between two groups (P>0.05).The incidences ofleukopenia ,thrombocytopenia,elevated AST,nausea,fatigue,feeling abnormal in the study group were higher than those in the control group (P<0.05).Conclusion The clinical effect of pemetrexed combined with oxaliplatin is superior to that of pemetrexed alone in the treatment of advanced NSCLC ,but it should pay attention to controlling a lot of adverse reactions .%目的：研究培美曲塞联合奥沙利铂治疗晚期非小细胞肺癌（NSCLC ）的临床疗效和安全性。

贝伐珠单抗联合培美曲塞治疗老年晚期肺腺癌的临床疗效及对机体免疫功能的影响韩磊！，张颖,张志国，卢桂龙,卢元丽，宋春青#(首都医科大学大兴教学医院肿瘤内科，北京102600)中图分类号R979.1文献标志码A文章编号1672-2124( 2020)12-1460-05DOI10.14009/j.issn.1672-2124.2020.12.014摘要目的：探讨贝伐珠单抗联合培美曲塞治疗老年晚期肺腺癌的临床疗效及对机体免疫功能的影响。

方法:采用前瞻性队列研究设计，纳入2015年a月至2018年12月首都医科大学大兴教学医院收治的符合入组标准的晚期肺腺癌患者，根据治疗方案的不同分为对照组和研究组。

对照组40例患者给予培美曲塞500mg/m2，静脉滴注，仅第1日给药，每21.为1个周期。

研究组42例患者给予培美曲塞500m/m2，静脉滴注，仅第1日给药，每21.为1个周期'贝伐珠单抗7.5m///静脉滴注，仅第1日给药，每14.为1个周期。

两组患者均接受至少4个周期的化疗，4个周期后比较两组患者的临床疗效、不良反应及外周血免疫指标变化，并随访疾病无进展生存期(progression free survival,PFS)$结果：研究组、对照组患者的客观有效率分别为52.4% (22/42)、37.5%(15/40)，差异无统计学意义(!=0.176)；疾病控制率分别为83.3%(35/42)、62.5%(25/40),差异有统计学意义(!二0.033)$研究组患者的中位PFS为6.5个月(95%C'：5.82〜7.29个月)，对照组患者的PFS为5.2个月(95%C'：4.45〜5.97个月)，两组比较，差异有统计学意义(!=0.04)$两组患者主要的3/4级不良反应包括中性粒细胞减少、血小板减少、贫血、恶心呕吐、乏力、高血压及蛋白尿，两组患者各不良反应发生率的差异均无统计学意义(！>0.05)$对照组患者治疗后T细胞亚群、自然杀伤细胞(NK细胞)活性、免疫球蛋白A(IgA)和免疫球蛋白M(IgM)水平明显降低，与治疗前比较的差异均有统计学意义(!< 0.05)'研究组患者治疗后T细胞亚群、NK细胞活性、IgA和IgM水平较治疗前降低不明显，与对照组治疗后的差异均有统计学意义(P<0.05)$治疗前后，两组患者IgG水平组內、组间比较，差异均无统计学意义(！>0.05)$结论：贝伐珠单抗联合培美曲塞治疗老年晚期肺腺癌的疗效确切,疾病控制率优于培美曲赛单药治疗，不良反应可耐受，对外周血免疫指标水平的影响相对较小$关键词贝伐珠单抗；培美曲塞；肺腺癌；免疫功能Clinical Efficacy of Bevacizumab Combined with Pemetrexed in the Treatment of Advanced Lung Adenocarcinoma in the Elderly and itr Effects on Immune FunctionHAN Lei#ZHANG Yin/,ZHANG Zhi/uo,LU Guilong,LU Yuanli#SONG Chunqin/(Dept.of Oncology#Daxing Teaching Hospital,Capital Medical University,Beijing102600,China)ABSTRACT OBJECTIVE:To probe inta the clinical eiicacy of bevacizumab combined with pemetrexed in the treatment of advanced lung adenocarcinoma in the elderly and its effects on immune function.METHODS:Prospective cohort study deign was adopted.Patienh with advanced lung adenocarcinoma who met the inclusion c V/V v and admitted into Daxing Teeching Hospital,Capital Medical University from Aug.2015to Dea.2018were divided into the controo group and the study group accarding ta dif fe vnt1x0x0.FoVy patients in tae controo group were given pemetrexed500mg/m2intravenously,and the drug was administered only on the fimi day,with21d foe one cycle.FoVy-tmo patients in the study group received pemetrexed500mg/m2intravenously,and the drug was adminttered only on the first day,with21d for one cycle；bevecizumab7.5m/]g intravenously,and the drug was administered ony on the first day,with14d for one cycle.Both groups received at leest4cycles of chemotheapy, and after4cycles,the clmical efficacy,adverse drug vections,and peapherae blood immuna indicators were compared betmeen tmo groups,and the disese prooression-free survival(PFS)was followed up.RESULTS:The objective effective rates in the study group and the conhco group were52.4%(22/42)and37.5%(15/40), respectively,with no statisticaHy signincant dOferenco(!=0.176);t he disesse conhco rates were vspetmSy83.3% (35/42)and62.5%(25/40),with statisticaHy significant diffms(!二0.033).The median PFS of the study group was6.5months(95%C/:from5.82to7.29months),whie that of the conhco group was5.2months(95%C/：from4.45to5.97months),the dmerenco was statisticaHy si/ificant(!=0.04).The main/ade3/4adverse drug*主任医师*研究方向：肿瘤的诊断及治疗*E-mail：zhan/h1029@#通信作者:主任医师*研究方向:肿瘤的靶向及免疫治疗*Emaii：0nychunqmyl63@163.cmreactions in two groups were neutropenia#thrombocytopenia#anemia#nausea and vomiting#fatigue#hypertension and proteinuria#and the dferency was not statisticylly signiOcynt(!>0.05).T cell subsets#NK cell activity#IgA and IgM levels in the controt group dmsed significyntly after treatwent#and the deferences were statisticyay significyni compared with thoss befoo treatwent(P<0.05).T cell subsets,NK cell activity#IgA and IgM kvels in the study group did not decreese signiVcently dfter treatwent,and the dference was statisticylly significent cempared with those in the centroo group dfter treatment(!<0.05).Before and aOer treatwent,there was no statisticylly significent dCerence in IgG levels between two groups(!>0.05).CONCLUSIONS:The efficacy of bevvcizumab combined with pemetrexed in the treatwent of advvnced lung adenocercinoma in the elderly is sivnincynt,the disess controo rate was supeOor te pemetrexacin monotherapy,wi U tolerabk advrss drug reactions,and the ejects on the lvl of peripheel immune indiceton are small.KEYWORDS Bevcizumab；Pemetexed;Lung adenocercinoma;Immune function肺腺癌（lung adenocarcinoma,LAC）是严重威胁人类健康和生命的恶性肿瘤之一*然而,大多数LAC患者在诊断时已经失去了手术的机会，以化疗为主的综合治疗是晚期LAC的主要治疗方法*目前，联合多种化疗药治疗晚期LAC已显示出显著的效果⑴*培美曲塞联合顺铂被美国临床肿瘤学会（American society of clinicel oncylogy,ASCO）推荐为晚期LAC 治疗的一线选择［旳，但其疗效似乎已达到瓶颈*近年来，贝伐珠单抗等新型靶向药物的临床应用为晚期恶性肿瘤患者带来了新的希望*贝伐珠单抗是一种有效的靶向药物，可阻断血管内皮生长因子（vvsculae endothelial gewth factoe,VEGF）与受体的结合，从而抑制血管的形成,抑制肿瘤生长目前,贝伐珠单抗联合培美曲塞及顺钳化疗已成为临床一线治疗方案。

培美曲塞与厄洛替尼二线治疗晚期非小细胞肺癌的临床疗效武宁妮;程静;吉兆宁【摘要】Objective:To evaluate the clinical efficacy,toxicity,quality of life and the median progression-free survival (PFS) using pemetrexed and erlo-tinib as second line medication for advanced non-small cell lung cancer ( NSCLC) .Methods:The clinical outcomes were retrospectively examined in 90 patients confirmed as NSCLC by histopathology or cytological examination ,who failed to respond to first-line of platinum-based regimen chemotherapy and underwent second line treatment with pemetrexed(n=46) or erlotinib(n=44) on outpatient or hospitalization basis between March 2011 and October 2013 in our department.Group pemetrexed received intravenous administration of pemetrexed in dose of 500 mg/m2 for 21 days as a chemotherapy epi-sodes,and group erlotinib were given oral erlotinib in dose of 150 mg/d by postprandial 2 hour.The two groups were assessed regarding the efficacy,pro-gression-free survival time (PFS),median survival time (MST),incidence of toxicity and life quality.Results:The two groups were not significant pertain-ing to effective rate,disease control rate,median PFS and MST(P>0.05).The adverse effects in group pemetrexed were associated with bone marrow sup-pression and gastrointestinal reactions;and erlotinib,development of skin rash and diarrhea,which was statistically different(P<0.05).Erlotinib had bet-ter improved the quality of life for patients thanpemetrexed(P<0.05).Conclusion:Although pemetrexed and erlotinib assecond line therapy for NSCLC may lead to similar effects and improvement of the quality of life for patients ,yet the adverse effects vary to a certain degree and erlotinib has better out-comes of life quality.%目的：比较培美曲塞与厄洛替尼单药治疗一线化疗进展的晚期非小细胞肺癌的疗效、不良反应、生活质量及生存期，为晚期非小细胞肺癌的二线用药提供参考。

培美曲塞二钠或多西他赛单药二线治疗晚期非小细胞肺癌的疗效和毒性分析田洁;张媛;俞邓枝;陈杰【摘要】目的探讨培美曲塞二钠或多西他赛单药二线治疗晚期非小细胞肺癌的疗效和毒性.方法选择48例经一线化疗失败的晚期NSCLC患者,按照随机数表法将其分为2组.2组分别实施培美曲塞二钠、多西他赛单药治疗,观察治疗后的不良反应、近期及远期疗效.结果 2组患者化疗后的近期疗效以及远期疗效比较,差异不具有统计学意义(P＞0.05);而培美曲塞二钠组患者化疗后的不良反应远低于多西他赛组,差异具有统计学意义(P＜0.05).结论培美曲塞二钠在保证对NSCLC的临床治疗效果的同时可以降低其不良反应.%Objective To investigate the efficacy and toxicity of pemetrexed disodium or docetaxel second-line treatment for advanced non-small cell lung cancer(NSCLC).Methods Select 48 NSCLC patients who failed first-line chemotherapy,and then randomly divided into 2 groups.The 2 groups were respectively treated with pemetrexed disodium and docetaxel.Then observed the side effects,short-term and long-term effects.Results Short-term efficacy and long-term efficacy of the 2 groups had no statistically significant difference (P ＞ 0.05);and adverse reactions of pemetrexed group after chemotherapy was much lower than that of docetaxel group,the difference was statistically significant(P ＜0.05).Conclusion Pemetrexed disodium for NSCLC can significantly improve the clinical efficacy and reduce adverse reaction.【期刊名称】《实用癌症杂志》【年(卷),期】2017(032)007【总页数】3页(P1146-1148)【关键词】培美曲塞二钠;多西他赛;非小细胞肺癌;疗效;毒性【作者】田洁;张媛;俞邓枝;陈杰【作者单位】232007 安徽省淮南朝阳医院;232007 安徽省淮南朝阳医院;232007 安徽省淮南朝阳医院;232007 安徽省淮南朝阳医院【正文语种】中文【中图分类】R734.2肺癌作为世界范围内恶性肿瘤中最常见的一种，据最新调查数据显示我国肺癌的发病率呈逐年上升趋势，逐步位居恶性肿瘤发病率的首位[1]。