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[非小细胞肺癌的辅助化疗:顺铂-培美曲塞联合治疗的耐受性]

[Adjuvant chemotherapy of non-small cell lung cancer: Tolerance of combined cisplatin-pemetrexed therapy].

作者信息

Gauvain C, Crequit P, Rousseau-Bussac G, Ganoun A, Baud M, Chouaid C

机构信息

Service de pneumologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France.

Service de pneumologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Service de pneumologie, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil, France.

出版信息

Rev Mal Respir. 2014 Nov;31(9):817-21. doi: 10.1016/j.rmr.2013.10.646. Epub 2013 Dec 30.

Abstract

RATIONALE

Adjuvant chemotherapy is standard for non-small cell lung cancer (NSCLC) after surgical resection. In this context, the tolerance of the treatment is an essential criterion in the choice of chemotherapy. This exploratory study evaluated, in the situation of adjuvant chemotherapy, the tolerance of combined cisplatin-pemetrexed. The study analyzed a cohort of non-squamous NSCLC patients treated in an adjuvant setting by combined cisplatin (75 mg/m(2)) and pemetrexed (500 mg/m(2)), under vitamin B12 and folic acid cover, 4 cycles at 21-day intervals.

RESULTS

The analysis included 23 patients (age: 58.7 ± 5 years, men: 56%, average creatinin clearance (Clea): 94 ± 22 mL/min, average haemoglobin: 13.8 ± 1.6g/dL). Over 92 planned courses, 7.6% are postponed (neutropenia), 4.3% were not given (asthenia). We noted 7 episodes of vomiting (4 grade 3), with two hospitalizations in the same patient; 5 episodes of anaemia grade 1-2 not requiring EPO prescription or transfusion and no febrile neutropenia. At the end of the treatment, three patients had a Clea<50 mL/mn and 5 a haemoglobin between 9 and 11 g/dL.

CONCLUSION

Combined cisplatin-pemetrexed in an adjuvant situation has a satisfactory tolerance.

摘要

理论依据

辅助化疗是非小细胞肺癌(NSCLC)手术切除后的标准治疗方法。在此背景下,治疗耐受性是化疗方案选择的重要标准。本探索性研究评估了在辅助化疗情况下顺铂联合培美曲塞的耐受性。该研究分析了一组非鳞状NSCLC患者,这些患者在维生素B12和叶酸覆盖下,接受顺铂(75mg/m²)联合培美曲塞(500mg/m²)辅助治疗,每21天为一个周期,共4个周期。

结果

分析纳入23例患者(年龄:58.7±5岁,男性:56%,平均肌酐清除率(Clea):94±22mL/min,平均血红蛋白:13.8±1.6g/dL)。在92个计划疗程中,7.6%的疗程推迟(中性粒细胞减少),4.3%的疗程未进行(乏力)。我们记录到7次呕吐发作(4次3级),其中同一患者住院2次;5次1 - 2级贫血发作,无需促红细胞生成素处方或输血,且无发热性中性粒细胞减少。治疗结束时,3例患者的肌酐清除率<50mL/min,5例患者的血红蛋白在9至11g/dL之间。

结论

辅助治疗中顺铂联合培美曲塞耐受性良好。

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