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[目的]观察培美曲塞二钠单药治疗老年非小细胞肺癌的临床疗效和不良反应。[方法]经病理学或细胞学确诊的老年(65～80岁)晚期ⅢA～Ⅳ期非小细胞肺癌43例,21例患者接受培美曲塞二钠500mg/m2治疗,静脉滴注,d1;22例患者接受吉西他滨1000mg/m2治疗,d1、8、15。21d为1个周期,接受2个周期以上化疗,每2个周期评估疗效、不良反应。[结果]培美曲塞二钠组和吉西他滨组临床获益率分别是57.14%和59.09%(P=0.897),中位生存期分别是9.5个月和8.9个月(P=0.813),1年生存率分别是28.6%和27.3%(P=0.9244)。两组主要的不良反应是骨髓抑制和胃肠道反应,其中培美曲塞二钠组中性粒细胞降低发生率明显低于吉西他滨组(Ⅰ～Ⅱ度:19.05%vs59.09%,P=0.0073,Ⅲ～Ⅳ度:9.52%vs27.27%,P=0.0261);培美曲塞二钠组胃肠道反应发生率也明显低于吉西他滨组(Ⅰ～Ⅱ度:14.29%vs59.09%,P=0.0017;Ⅲ～Ⅳ度:4.76%vs40.91%,P=0.0050)。[结论]培美曲塞二钠和吉西他滨单药治疗老年非小细胞肺癌疗效均较好,但培美曲塞二钠不良反应低于吉西他滨。
[Objective] To observe the clinical efficacy and adverse reactions of pemetrexed disodium monotherapy in the treatment of elderly non-small cell lung cancer. [Methods] Forty-three patients with advanced stage ⅢA-Ⅳ non-small cell lung cancer (65-80 years) diagnosed by pathology or cytology were enrolled. 21 patients received pemetrexed disodium 500mg / m2, intravenous drip, d1 ; 22 patients received gemcitabine 1000mg / m2 treatment, d1, 8,15.21d for a cycle, more than two cycles of chemotherapy, evaluation of the efficacy of every 2 cycles, adverse reactions. [Results] The clinical benefit rates of pemetrexed disodium group and gemcitabine group were 57.14% and 59.09% respectively (P = 0.897), and the median survival time was 9.5 months and 8.9 months (P = 0.813), respectively The annual survival rates were 28.6% and 27.3%, respectively (P = 0.9244). The main adverse reactions of the two groups were myelosuppression and gastrointestinal reactions. The incidence of neutropenia in the pemetrexed disodium group was significantly lower than that in the gemcitabine group (Ⅰ ~ Ⅱ degrees: 19.05% vs59.09%, P = The incidence of gastrointestinal reactions in pemetrexed disodium group was also significantly lower than that in gemcitabine group (Ⅰ ~ Ⅱ degree: 14.29% vs59.09%, P0.05, Ⅲ ~ Ⅳ: 9.52% vs27.27%, P = 0.0261) , P = 0.0017; Ⅲ ~ Ⅳ degrees: 4.76% vs 40.91%, P = 0.0050). [Conclusions] Pemetrexed disodium and gemcitabine monotherapy in the treatment of elderly non-small cell lung cancer have good curative effect, but adverse reactions of pemetrexed disodium are lower than gemcitabine.