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目的悪性胸膜中皮腫に対するペメトレキセドを含む化学療法の効果と有害事象についてレトロスペクティブな検討を行った方法2007年2月2009年12月に長崎胸部腫瘍研究グループ関連施設においてペメトレキセドを含む化学療法を行った悪性胸膜中皮腫34例を検討結果男性28例女性6例年齢中央値68歳5381歳でアスベスト曝露があった症例は26例病理組織型は上皮型16例肉腫型10例二相型5例不明3例であった初回化学療法25例既治療8例30例がペメトレキセド・シスプラチン併用療法3例がペメトレキセド・カルボプラチン併用療法1例がペメトレキセド単剤療法を受けていたペメトレキセド500 mg/m2・シスプラチン75 mg/m2併用療法を受けた24例のGrade 3以上の毒性は白血球減少2例8.3好中球減少5例20.8消化器毒性2例8.3で奏効率12.5生存期間中央値14.4ヶ月であった結論実臨床でのペメトレキセド・シスプラチン併用療法の効果と有害事象は過去の前向き試験の結果とほぼ同程度であったObjective. We analyzed the clinical features and outcomes of malignant pleural mesothelioma patients treated with pemetrexed. Method. From February 2007 to December 2009, 34 patients enrolled with the Nagasaki Thoracic Oncology Group were treated with pemetrexed. Results. Of the 34 patients, 28 were men and 6 were women with a median age of 68 years old (range 53 to 81). Twenty-six patients (76.5%) had exposed to asbestos. The histological subtype was epithelioid in 16 patients, sarcomatoid in 10 patients, biphasic in 5 patients, unknown in 3 patients. Twenty-five patients were chemotherapy-naive patients and 8 patients had received prior chemotherapy. Thirty patients had received pemetrexed and cisplatin chemotherapy. Three patients had received pemetrexed and carboplatin chemotherapy. One patient had received pemetrexed monotherapy. In pemetrexed (500 mg/m 2) and cisplatin (75 mg/m 2) group, grade 3 or 4 leukocytopenia was recorded in 2 patients (8.3%), grade 3 or 4 neutropenia was recorded in 5 patients (20.8%), grade 3 or 4 gastrointestinal toxicities were recorded in 2 patients (8.3%). The response rate was 12.5%, the median survival was 14.4 months. Conclusion. In this study clinical efficacy and toxicities of malignant pleural mesothelioma patients treated with pemetrexed and cisplatin chemotherapy are comparable to previous prospective studies

A Clinical Study of 34 Malignant Pleural Mesothelioma Patients Treated with Pemetrexed from Nagasaki Thoracic Oncology Group