培美曲塞联合卡铂与吉西他滨联合卡铂一线治疗晚期非鳞非小细胞肺癌的临床观察

Clinical study comparing pemetrexed plus carboplatin with gemcitabine plus carboplatin as first-line treatment in patients with advanced nonsquamous non-small cell lung cancer

目的:观察培美曲塞联合卡铂与吉西他滨联合卡铂治疗晚期非鳞非小细胞肺癌(NSCLC)的近期疗效及毒副反应。方法:57例ⅢB-Ⅳ期经病理组织学和(或)细胞学检查确诊的晚期非鳞NSCLC患者,其中培美曲塞组(PC组)26例,吉西他滨组(GC组)31例,分别给予培美曲塞联合卡铂和吉西他滨联合卡铂方案治疗至少2周期以上,评价其近期疗效及毒副反应。结果:PC组和GC组的客观缓解率(42.3%vs 41.9%),疾病控制率(88.5%vs 80.6%),中位无进展生存期(5.9个月vs 4.7个月)差异均无统计学意义(P>0.05)。两组的主要毒副反应均为骨髓抑制和胃肠道反应,PC组Ⅲ-Ⅳ度血小板减少的发生率明显低于GC组(P=0.042)。结论:培美曲塞联合卡铂和吉西他滨联合卡铂一线治疗晚期非鳞NSCLC疗效相近,培美曲塞组不良反应轻,安全性更好。

AIM： To observe the clinical efficacy and adverse effect of Pemetrexed combined with Carboplatin and Gemcitabine combined with Carboplatin to treat non-squamous non-small cell lung cancer. METHODS： 57 pathologically confirmed patients with III B/IV staged NSCLC were recruited in this study. 26 patients treated with Pemetrexed plus Carboplatin （PC group） and 31 with Gemcitabine plus Carboplatin （GC group） more than 2 cycles. The latest clinical efficacy and adverse effect were evaluated. RESULTS： No statistical difference was observed in objective response rate（ORR） （42.3% vs 41.9%）, disease control rate （ 88.5% vs 80.6%） and median progression free survival （PFS）（5.9 months vs 4.7 months） between the PC group and GC group. The main common adverse reactions were myelosuppression and gastrointestinal response in both groups. The rates of III-IV degree thrombocytopenia were obviously less observed on the PC group compared with GC group. CONCLUSION.. The both groups have similar clinical efficacy as the treatment of Nonsquamous NSCLC, but the Pemetrexed combined with Carboplatin has better safety and less reaction.