培美曲塞联合卡铂治疗非小细胞肺癌40例临床观察

Clinical trials of pemetrexed combined with carboplatin in treating 40 non-small cell lung cancer patients

目的:培美曲塞(PEM)是一种多靶点抗叶酸化疗药,目前已成为晚期非小细胞肺癌二线治疗的标准药物。本研究回顾分析培美曲塞联合铂类治疗非小细胞肺癌的临床疗效及不良反应。方法:选择经病理学证实的非小细胞型肺癌患者40例,予以培美曲塞二钠500 mg/m2静脉滴注,联合卡铂常规剂量第1d、21d为1周期,每例患者至少化疗2个周期(观察组),并与吉西他滨(GEM)+卡铂方案做对照(对照组),评价疗效及不良反应。结果:治疗2个周期后PEM组有效率50%,GEM组有效率45%。主要为骨髓抑制及胃肠道反应,PEM组的骨髓抑制、胃肠道反应、AST、尿素氮及皮疹、脱发的发生率明显低于GEM组,2组不良反应比较差异有统计学意义(P<0.05)。结论:培美曲塞二钠联合卡铂治疗非小细胞型肺癌临床疗效明显,不良反应少。

bjective： Pemetrexed （PEM） is a multi-targeted chemotherapeutic agent for antifolate drugs. PEM has become the standard agent for the second-line treatment of advanced non-small cell lung cancer （NSCLC）. This study aims to review and analyze the clinical efficacy and adverse reactions of PEM combined with carboplatin with respect to NSCLC treatment. Methods： A total of 40 patients suffering from NSCLC were selected and confirmed by pathology. On the first day of treatment, the conventional 500 mg/m2 dose of pemetrexed disodium was infused intravenously. On the second day, a combined therapy with carboplatin was conducted based on the conventional dose for a 21-day cycle with at least two cycles for each patient. The therapeutic efficacy and adverse reactions were evaluated and were compared with the proposed regimen of gemcitabine （GEM） combined with carboplatin. Results： After two cycles of the treatment, the curative effects of the PEM and GEM groups were 50% and 45%, respectively. The main adverse reactions are bone marrow suppression and gastrointestinal reactions. The incidence rates of bone marrow suppression, gastrointestinal reactions, amisulpride/AST, urea nitrogen, rash, and hair loss were obviously lower in the PEM group than in the GEM group. Statistically significant differences in adverse reaction were found between the two groups （P〈0.05）. Conclusion： The use of the combination regimen of PEM with carboplatin showed significantly more clinical effects and less adverse reactions for NSCLC treatment.