Chemotherapy with Pemetrexed Alone in the Treatment for 21 Elderly Cases with Non-small Cell Lung Cancer

[Purpose] To investigate the response and side effect of pemetrexed alone in the treatment for elderly patients with non-small cell lung cancer (NSCLC). [Methods] Forty-three elderly cases with NSCLC stage Ⅲ A ～ Ⅳ confirmed by pathology or cytology were divided into permetrexed group (n=21) and gemcitabine group (n=22). Patients in pemetrexed group received pemetrexed 500mg/m 2 , iv drip,d 1 ; patients in gemcitabine group received gemcitabine1000 mg/ m 2 , iv drip,d 1,8,15 . Every 21 days as a cycle. All patients received 2 cycles chemotherapy, and the response and side effect were evaluated every 2 cycles. [Results] The clinical benefit rate in pemetrexed group and gemcitabine group was 57.14% and 59.09% (P =0.897) respectively.The median survival time was 9.5 and 8.9 months (P=0.813) respectively. The 1-year survival rate was 28.6% and 27.3% (P =0.9244) respectively. The main side effects were myelosuppression and gastrointestinal toxicity. The neutropenia rate in pemetrexed group was significantly less than that in gemcitabine group (gradeⅠ～Ⅱ: 19.05% vs 59.09% ,P=0.0073; grade Ⅲ～Ⅳ:9.52% vs 27.2%, P =0.0261). The gastrointestinal toxicity in pemetrexed group was significantly less than that in gemcitabine group (grade Ⅰ～Ⅱ: 14.29% vs 59.01%, P=0.0017;grade Ⅲ～Ⅳ:4.76% vs 40.91% , P=0.0050). [Conclusion] Chemotherapy with pemetrexed or gemcitabine for elderly patients with advanced NSCLC is effective, but the side effect of pemetrexed is lower than that of gemcitabine.