培美曲塞和多西他赛分别与顺铂联用治疗非小细胞肺癌的效果观察

Efficacy of pemetrexed or docetaxel plus cisplatin in treatment of patients with non-small cell lung cancer

目的观察培美曲塞和多西他赛分别联合N$13治疗非小细胞肺癌（NSCLC）的临床疗效及不良反应发生情况。方法共纳入NSCLC患者54例。培美曲塞组28例，接受培美曲塞500-600mg／m^2＋顺铂75mg／m^2治疗，第1天。多西他赛组26例，给予多西他赛70—80mg／m^2＋顺铂75mg／m^2治疗，第1天。2组均应用地塞米松预防过敏。3周为1个化疗周期，化疗3个周期。观察化疗期间疗效及药物不良反应。结果培美曲塞组患者部分缓解10例（35．7％），稳定14例（50．0％），进展4例（14．3％），客观缓解率为35．7％，疾病控制率为85．7％。多西他赛组部分缓解9例（34．6％），稳定13例（50．0％），进展4例（15．4％），客观缓解率为34．6％，疾病控制率为84．6％。2组药物客观缓解率和疾病控制率差异无统计学意义（均P〉0．05）。多西他赛组血液毒性和脱发发生率明显高于培美曲塞组[分别为65．4％（17／26）比50．0％（14／28），23．1％（6／26）比0．0；均P〈0．05]。结论培美曲塞联合顺铂与多西他赛联合顺铂治疗NSCLC近期疗效相似，但培美曲塞不良反应更小。

Objective To compare the efficacy and toxicity of pemetrexed ordocetaxel plus cisplatin in treatment of patients with non-small cell lung cancer （NSCLC）. Methods All 54 patients with NSCLC were en- rolled in the study. The pemetrexed group （ n = 28 ） were treated with pemetrexed （ 500-600 mg/m^2 ） combined cis- platin （75 mg/m^2d1 ）. The docetaxel group （n = 26） were treated with docetaxel （70-80 mg/m^2） combined with cisplatin （75 mg/m^2d1 ）. Both groups were given dexamethasone to prevent allergy. Twenty-one days were acted as one course, and the effect was evaluated after at least two courses. Results The remission rate and disease control rate in pemetrexed group and docetaxel group were 35.7% （ 10/28）, 85.7% （24/28） and 34.6% （9/26）, 84.6% （22/26） respectively （P 〉 0.05 ）. The side effect （hematologic toxicity and alopecia） incidence rate in the peme- trexed group was significantly lower than that in the doeetaxel group [ 50.0% （ 14/28 ） vs 65.4% （ 17/26 ）, 0 vs 23.1% （6/26）, all P 〈 0.05 1- Conclusion The efficacy of pemetrexed combined eisplatin and eocetaxel com- bined csplatin for the treatment of NSCLC patients have no significant difference, while the side effect incidence rate shows significant difference.