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目的观察培美曲塞在750～800mg/m2时的不良反应,分析血液学毒性与既往化疗强度的相关性及客观疗效。方法采用开放、非随机方法收集28例患者,培美曲塞(PEM)每个疗程总剂量750～800mg/m2,分第1、8天静脉滴注10min以上,每3～4周重复。每2个疗程评价疗效,治疗至患者病情进展、出现严重不良反应或患者自动退出。结果 28例患者全部可评价不良反应,3/4度骨髓抑制的发生率为14.3%,既往出现过类似反应患者的发生率为36.4%。26例可评价疗效的患者中,有效率为19.2%,稳定率为61.5%;既往进行3种以下方案化疗组与3种或以上方案组之间的有效率,分别为16.7%和21.4%,稳定率分别为58.3%和64.3%。15例非小细胞肺癌患者,有效率为20%,稳定率为60%。结论 PEM 750～800mg/m2是安全的,既往化疗出现3/4度骨髓抑制是严重血液学毒性的高危因素,结果显示可提高患者的客观疗效。
Objective To observe the adverse reactions of pemetrexed at 750 ~ 800mg / m2, and to analyze the correlation between hematological toxicity and the previous chemotherapy intensity and the objective curative effect. Methods A total of 28 patients were enrolled in the study. The total dose of pemetrexed (PEM) was 750-800 mg / m2 for each course of treatment. The patients were intravenously dripped for more than 10 minutes every day and day 1, and repeated every 3 to 4 weeks. Evaluation of the efficacy of each course of 2 courses of treatment until the patient’s progress, serious adverse reactions or patients with automatic withdrawal. Results All the 28 patients could be evaluated for adverse reactions. The incidence of 3/4 myelosuppression was 14.3%. The incidence of previous similar reactions was 36.4%. Among the 26 evaluable patients, the effective rate was 19.2% and the stability rate was 61.5%. Previously, the effective rates were 16.7% and 21.4% among the three chemotherapy regimens and three or more regimens, respectively. The stability rates were 58.3% and 64.3% respectively. 15 cases of non-small cell lung cancer patients, the effective rate was 20%, the stability rate was 60%. Conclusions PEM 750-800mg / m2 is safe. The 3/4-degree myelosuppression in previous chemotherapy is a high risk factor for severe hematological toxicity. The results show that it can improve the objective curative effect.