培美曲塞联合支持治疗在一线治疗后复发或对一线-第三军医大学学报.DOC

培美曲塞在恶性胸膜间皮瘤病人中二线治疗疗效 王姗1), 王贵吉1) #, 裴迎新2), 张丽静1)，韩丹丹1) 1) 河南省郑州市郑州大学第一附属医院肿瘤科 郑州 450052 2) 河南省郑州市郑州大学公共卫生学院营养与食品卫生学教研室郑州 450001 # 通讯作者,男,1953年10月生,本科,教授,主任医师,研究方向: 恶性肿瘤的内科治疗, Email: wangguijzzu@163.com 关键词：培美曲塞；恶性胸膜间皮瘤；对症支持治疗 中图分类号：R734.3 摘要 目的：探讨培美曲塞联合支持治疗与单纯支持治疗对进展恶性胸膜间皮瘤患者生存时间、疾病无进展生存期、药物敏感性、药物安全性的差异。方法：选择一线方案不敏感或治疗后复发的恶性胸膜间皮瘤病人26例，培美曲塞联合支持治疗者11例；单纯对症支持治疗者15例。结果：两种方案中位生存时间无明显差异（治疗组8.1个月，对照组 7.6个月；P=0.775）；中位疾病无进展生存期分别为3.2个月、1.7个月（P＜0.005）；部分缓解率分别为18.2%和0%，疾病控制率为63.6%和13.3%。约7%病人出现Ⅲ-Ⅳ度血液毒性，化疗可被耐受。结论：培美曲塞联合支持治疗在进展的恶性胸膜间皮瘤病人中显示出明显疗效。 Pemetrexed in previously Treated patients with malignant pleural mesothelioma WANG Shan 1), WANG Guiji 1), PEI Yingxin 2), ZHANG Lijing1)，HAN Dandan1) 1 ) Department of Oncology ,the First Affiliated Hospital, Zhengzhou Un iversity , Zhengzhou 450052 ，China
2) Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001，China Key words: Pemetrexed; Malignant pleural mesothelioma; Best supportive care Abstract Aim To detect the difference of the efficacy between pemetrexed combined with best supportive care and single best supportive care in patients with advanced malignant pleural mesothelioma. Methods A total No. of 26 cases of Malignant pleural mesothelioma including 11 cases treated by pemetrexed combined with best supportive care and 15 cases treated only by best supportive care. Results Median OS time was not significantly different between treatment group and control group(8.1and 7.6months;P=0.775).Median progression-free survival is separately 3.2 months and 1.7 months(P＜0.005). Partial response was achieved in 18.2% and 0% and the disease control rate was achieved in 63.6% and 13.3%. Only 7% patients had modest grade 3 and 4 hematologic toxicities, the chemotherapy was well tolerated. Conclusion Second-line pemetrexed had significant tumor response compared with BSC alone in patients with advanced MPM. 恶性胸膜间皮瘤（Malignant pleural mesothelioma,MPM）生长于胸膜间皮组织表面，多数患者发病与石棉接触有关，是一种隐