培美曲塞联合顺铂在晚期男性肺腺癌一线治疗中的应用

Application of pemetrexed plus cisplatin as first-line treatment in male patients with ad vanced lung adenocarcinoma

目的:观察培美曲塞联合顺铂(PP组)与吉西他滨联合顺铂(GP组)作为一线化疗药物治疗晚期男性肺腺癌的疗效及毒副反应。方法:将74例经病理证实的晚期男性肺腺癌患者(Ⅲb和Ⅳ期)分为两组:GP组40例,PP组34例。PP组:培美曲塞500mg/m2,静脉滴注,第1天,持续3-4h;顺铂(DDP)75mg/m2,静脉点滴,第1天,每21天为1个周期。GP组:吉西他滨1250mg/m2,静脉点滴,第1、8天;顺铂用法同上,每3周为1个周期。连续4-6个周期。每2周期评价疗效及毒副反应。结果:PP组总有效率[完全缓解(CR)+部分缓解(PR)]为44.1%,1年生存率为38.2%;GP组总有效率为42.5%,1年生存率为37.5%,两组间总有效率和1年生存率比较均无统计学意义(P>0.05)。最常见的毒副反应是骨髓抑制和胃肠道反应,其中骨髓抑制两组间比较差异有统计学意义(P<0.05)。结论:培美曲塞联合顺铂方案可作为一线治疗晚期男性肺腺癌的选择。

Objective：To observe the efficacy and toxicity of pemetrexed plus platinum versus gemcitabine plus platinum with advanced male lung adenocarcinoma. Methods： We retrospectively reviewed 74 advanced male lung ad- enocarcinoma patients. 34 patients received pemetrexed 500mg/m2 d; plus cisplatin 75mg/m2 dl ; and anothers re- ceived gemcitabine（ 1250mg/m2, d1, ds ） plus cisplatin 75mg/m2 dl on every 21 days. Consecutive 4 - 6 cycles. The efficacies and side effects were assessed after 2 cycles of chemotherapy. Results：In group PP and group GP,the total efficiency of treatment （ CR ＋ PR） was 44.1% and 42.5 % respectively （ P 〉 0.05 ）, and the 1 year overall survival was 38.2% and 37.5% （P 〉 0.05 ）. The most common side effects were bone marrow suppression and gastrointestinal reactions. Compared to group GP, the side effects such as bone marrow was milder and survival quality higher in group PP（P 〈0.05）. Conclusion：Pemetrexed plus cisplatin could be used as first- line treatment in male patients with advanced lung adenocarcinoma.