培美曲塞或多西他赛联合顺铂治疗晚期NSCLC临床对照研究

Comparison analysis of pemetrexed and docetaxel plus cisplatin in treatment of advanced non-small cell lung cancer

目的:对比培美曲塞与多西他赛联合顺铂治疗晚期非小细胞肺癌(NSCLC)的近期疗效和毒副作用。方法:将48例NSCLC患者随机分为观察组(n=25)和对照组(n=23)。观察组给予培美曲塞联合顺铂治疗,对照组给予多西他赛联合顺铂治疗,21d为1个周期,2个周期后评价疗效,每个周期进行1次毒副作用评价。结果:观察组与对照组客观有效率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)分别为36.0%(9/25)和30.4%(7/23)、84.0%(21/25)和84.0%(18/23)、9.3和8.9个月,两组比较差异无统计学意义,χ2值分别为0.167、0.159和1.576,P值分别为0.683、0.611和0.209。但观察组中性粒细胞减少及脱发的发生率显著低于对照组,分别为28.0%和56.5%、28.0%和60.9%,差异有统计学意义,χ2值分别为4.009和5.259,P值分别为0.045和0.022。结论:培美曲塞联合顺铂与多西他赛联合顺铂的近期疗效相当,但前者毒副作用较后者轻,提高了化疗耐受性,适合临床进一步推广应用。

OBJECTIVE： To compare the short-term effect and toxicity reactions between pemetrexed and docetaxel plus cisplatin for advanced non-small cell lung cancer（NSCLC）. METHODS： Forty eight patients of NSCLC were divided into two groups. The observation group （n= 25） received pemetrexed plus cisplatin, and the control group （n= 23） received docetaxel plus cisplatin. Twenty-one days were acted as one course. The effect was evaluated after two courses, and the toxicity reactions were e- valuated every course. RESULTS： The ORR, DCR and PFS in the two groups were respectively 36.0% vs 30.4%, 84.0% vs 84.0 %, 9.3 months vs 8.9 months, with no significant difference （X2 were 0. 167,0. 159 and 1. 576 respectively）, P were 0. 683, 0. 611 and 0. 209 respectively. But the rates of neutropenia and alopecia in observation group were obviously lower than that in control group（28.0% vs 56.5% ,28.0% vs 60.9% ,X2 were 4. 009 and 5. 259,P were 0. 045 and 0. 022 respectively）. CONCLU- SION： Pemetrexed and docetaxel plus cisplatin on NSCLC have similar short-term effects, but toxicity reactions in the former are slighter than that in the latter. It can increase the tolerance and is appropriate to be popularized more.