Original Article
Efficacy and survival analysis of first-line and sequential maintenance chemotherapy in elderly patients with non-small cell lung cancer
Yu Min, Tian Yingxuan, Sun Li, Wang Jun, Song Min, Zhu Jianfei, Bai Jun
Published 2019-01-20
Cite as J Chin Physician, 2019, 21(1): 19-22. DOI: 10.3760/cma.j.issn.1008-1372.2019.01.006
Abstract
ObjectiveTo analyse the clinical effect and safety of Alimta (Pemetrexed) combined with cisplatin treatment (PP) on elderly patients with non small cell lung cancer (NSCLC).
MethodsWe retrospectively analyzed the clinical data of 40 cases of NSCLC patients treated with Pemetrexed combined with cisplatin for first-line chemotherapy, and 24 cases of them continually received single Pemetrexed for maintenance treatment (PP+ C). Then we compared the results with 35 patients in the non-Pemetrexed regimen (control group) and 26 patients with best supportive care (BSC) in the same period. The adverse reactions and short-term efficacy [response rate (RR), disease control rate (DCR)] were evaluated. Time to progression (TTP), median survival time (MST), one-year and three-year survival rates and follow-up overall survival (OS) were calculated.
ResultsAmong 40 patients with Pemetrexed regimen, 2 patients had complete remission (CR), and the RR was 47.8%, which was better than 42.8% (P=0.026) in the control group. The main adverse reactions of pemetrexed regimen were myelosuppression, fatigue, nausea and vomiting, but all were tolerated and no treatment-related death occurred. 24 patients received single Pemetrexed maintenance therapy. The MST of the PP+ C group was superior to the other groups (P=0.03, P<0.05); the median OS of the PP+ C group, the control group, and the BSC group reached 13.2, 10.4 months and 8.6 months, respectively (P<0.001).
ConclusionsFor elderly patients with advanced NSCLC, especially adenocarcinoma, the combination of Pemetrexed and cisplatin is a better treatment option. It is convenient to administer and has less toxicity and adverse reactions related to chemotherapy. Patients with better PS score after first-line treatment can obtain longer survival period after maintenance treatment.
Key words:
Pemetrexed; Antineoplastic combined chemotherapy protocols; Carcinoma, non-small-cell lung; Aged
Contributor Information
Yu Min
Department of Oncology Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Tian Yingxuan
Department of Elderly Respiratory Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Department of Elderly Respiratory Medicine, Hospital of Xi′an Medical College, Xi′an 710068, China
Sun Li
Department of Elderly Respiratory Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Department of Elderly Respiratory Medicine, Hospital of Xi′an Medical College, Xi′an 710068, China
Wang Jun
Department of Elderly Respiratory Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Song Min
Department of Elderly Respiratory Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Zhu Jianfei
Department of Thoracic Surgery, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
Bai Jun
Department of Oncology Medicine, the Shaanxi Provincial People′s Hospital, Xi′an 710068, China
