两个化疗方案治疗晚期非小细胞肺癌疗效观察

Efficacy comparison of two second-line chemotherapy to patients with advanced non-small-cell lung cancer

目的比较培美曲塞二钠和多西他赛单药用于治疗一线化疗失败的晚期非小细胞肺癌（NSCLC）患者的疗效及安全性。方法选择该院2006年10月至2008年5月NSCLC（ⅢB~Ⅳ期）患者86例,随机分为培美曲塞二钠组（n=28）,应用培美曲塞二钠500 mg/m2,静脉滴注10 min;多西他赛组（n=58）,应用多西他赛75 mg/m2,静脉滴注1 h,均治疗21 d为1个疗程,治疗2个疗程后比较疗效。结果培美曲塞二钠组部分缓解（PR）2例,稳定（SD）17例,进展（PD）9例,总有效率为7.14%,疾病控制率为67.86%;多西他赛组PR 6例,SD 35例,PD 17例,总有效率为10.34%,疾病控制率为70.69%。培美曲塞二钠组严重中性粒细胞下降（Ⅲ~Ⅳ度）、血红蛋白下降（Ⅰ~Ⅱ度）和皮疹（Ⅰ~Ⅱ度）发生率（7.14%,10.71%和10.71%）与多西他赛组（24.14%、58.62%和0）比较,差异有统计学意义（P〈0.05）;其他不良反应的发生率差异无统计学意义（P〉0.05）。结论对于一线化疗失败的晚期NSCLC患者,单药使用培美曲塞二钠或多西他赛化疗疗效相似,均安全、有效。

Objective To compare the efficacy and safety of domestic pemetrexed and docetaxel singly used in treatment of patients with advanced non-small-cell lung cancer（NSCLC） who previously failed with first-line chemotherapy.Methods 86 patients with stage-ⅢB or stage-Ⅳ NSCLC who couldn′t bear or failed in previous first-line chemotherapy were assigned to two groups：28 patients received pemetrexed 500 mg/m2 and 58 patients received docetaxel 75 mg/m2.All eligible patients received 2 cycles chemotherapy at least,31 d for each cycle.Results There were 2 cases of PR,17 cases of SD,9 cases of PD in P group,and the total response rate was 7.14%,and disease control rate was 67.86%.There were 6 cases of RR,35 cases of SD,17 cases of PD,in P group and the total response rate was 10.34%,disease contal rate was 70.69%.The decrease rate of neutrophile granulocyte and hemoglobin,and occurence of rash in P group were significantly different from the corresponding itcm in P group（P0.05）,the occurencs of other adverse reaction of the two groups were almost the same（P0.05）.Conclusion Treatment with pemetrexed and docetaxel results in clinically equivalent efficacy in treatment of patients with advanced non-small-cell lung cancer（NSCLC）who previously failed with first-line chemotherapy.Both of the two treatments are safe and effective.