培美曲赛二钠联合顺铂一线治疗晚期非小细胞肺癌的临床观察

Clinical observation of Pemetrexed Disodium combined with Cisplatin as the first-line treatment for advanced non-small cell lung cancer

目的:探讨培美曲赛联合顺铂方案对比其他含铂的一线治疗晚期非小细胞肺癌(NSCLC)方案(紫杉醇、吉西他滨及长春瑞滨)的疗效及安全性。方法:将34例患者随机分为两组,实验组16例患者接受培美曲赛联合顺铂治疗,培美曲赛二钠500mg/m2d1加入0.9%氯化钠注射液100ml,静滴超过10min;顺铂75mg/m2d1、2、3。对照组18例(紫杉醇,吉西他滨或长春瑞滨)联合顺铂组,用药紫杉醇150mg/m2d1,或吉西他滨1000mg/m2d1、d8,或长春瑞滨30mg/m2d1、d8,加入0.9%氯化钠注射液静滴;顺铂75mg/m2d1、2、3。每21天为1个周期。2个周期评价疗效和不良反应。结果:实验组总有效率(ORR)为25.0%,对照组为16.7%,两组间差异无统计学意义(P>0.05﹚,TTP及OS差异无统计学意义,但血液毒性及消化道反应,实验组均低于对照组。结论:培美曲赛二钠联合顺铂治疗一线晚期非小细胞肺癌有效,毒性低,有较好的耐受性。

Objective： To compare the efficacy and the safety of Pemetrexed Disodium combined with Cisplatin with those of GEM, PTX or NVB combined with cisplatin for the first-line treatment of advanced non-small cell lung cancer. Methods： Thirty-four cases of patients with advanced non-small cell lung cancer were randomly divided into two groups. In treatment group, 16 patients of advanced NSCLC were received premetrexed 500 mg/m2 d1, in 0.9% sodium chloride injection 100 ml, 10 min intravenous drip, cisplatin 75 mg/m2 d1,2,3. In control group, PTX 150 mg/m2 d1 or GEM 1 000 mg/m2 d1,d8 or NVB 30 mg/m2 d1,d8, in 0.9% sodium chloride Injection 100 ml, intravenous drip, cisplaton 75 mg/m2 d1, 2, 3. Every 21 days as one cycle, the efficacy and adverse reaction after 2 cycles were evaluated. Results： ORR of the treatment group were 25.0% and the control group were 16.7%, there was no significant differences between them （P0.05）, the TTP and the OS of the two groups had no significant differences either, but hematological toxicity and gastrointestinal toxicity of the treatment group were obviously less than those of the control group. Conclusion： As the first-line treatment of advanced non-small cell lung cancer, pemetrexed disodium （pem） combined with cisplatin has more stable efficacy, lower toxicity and better tolerability.