培美曲塞二钠联合奈达铂治疗晚期肺腺癌的临床研究

Clinical observation of efficacy of pemetrexed plus nedaplatin in treatment of patients with advanced lung adenocacinoma

目的:观察培美曲塞二钠(PEM)及多西他赛(DTX)分别联合奈达铂(NDP)治疗晚期肺腺癌的临床疗效及不良反应。方法:共收集225例经病理和(或)细胞学确诊的中晚期肺腺癌患者,随机分为培美曲塞组(109例)和DTX组(116例)。培美曲塞组采用PEM和NDP方案联合化疗,PEM 500mg/m2,静脉滴入,d1;NDP 80mg/m2,静脉滴入,d1,21d为1个周期;DTX组采用DTX和NDP方案联合化疗,DTX 75mg/m2,静脉滴入,d1;NDP 80mg/m2,静脉滴入,d1,21d为1个周期。结果:培美曲赛组治疗有效率及控制率均比DTX组高,差异有统计学意义(χ2=2.35,P=0.041;χ2=4.23,P=0.033)。培美曲赛组与DTX组不良反应两组间相比较差异均无统计学意义。其中不良反应发生率较高的是血红蛋白下降、白细胞下降和血小板下降,而肝肾功能损害较为少见,恶心、呕吐和食欲不振的发生率较低。结论:PEM联合NDP方案治疗晚期肺腺癌患者疗效好,不良反应较轻,患者耐受性好,值得在临床进一步推广验证。

OBJECTIVE： To compare the efficacy and safety of pemetrexed or docetaxel plus nedaplatin in treatment of patients with advanced lung adenocacinma.METHODS： Totally 225 patients with advanced lung.adenocacinma were assigned to two groups： 109 patients received pemetrexed 500 mg/m2 plus nadapaltin 80 mg/m2（d1） and 116 patients received docetaxel 75 mg/m2 plus nadapaltin 80 mg/m2（d1）.21 days as a cycle.RESULTS： Efficiency and control rate of pemetrexed group was higher than that of docetaxel group,and there was significant difference（χ2=2.35,P=0.041;χ2=4.23,P=0.033）.Adverse reactions of pemetrexed group and docetaxel group showed no significant difference.Higher incidence of adverse reactions was hemoglobin decreased,leukopenia and thrombocytopenia,and rare liver and kidney dysfunction,nausea,vomiting and a low incidence of loss of appetite.CONCLUSION： Pemetrexed plus nedaplatin have the same activity as docetaxel plus nedaplatin in treatment of patients with advanced lung adenocacinoma,and they appeares to be more tolerated.