培美曲塞分别联合奈达铂或者顺铂在晚期肺腺癌的临床观察

A clinical observation about pemetrexed combined with nedaplatin or cisplatin as the initial treatment for advanced pulmonary adenocarcinoma

目的：评价培美曲塞联合奈达铂在晚期肺腺癌一线化疗的疗效及不良反应。方法回顾性分析我院2008年6月至2013年6月收治的晚期肺腺癌72例，按纳入标准及用药方案，分为研究组和对照组，两组均给予培美曲塞500 mg/m2静脉滴注化疗，d1，研究组联合奈达铂80 mg/m2静脉滴注， d2，对照组予顺铂80 mg/m2静脉滴注化疗，d2，至少化疗2周期后评价疗效。结果研究组和对照组在近期疗效比较无统计学差异，ORR分别为51.5%和53.8%，DCR分别为63.6%和71.8%。不良反应比较，3～4级毒性研究组以中性粒细胞减少、血小板下降为主，对照组以恶心呕吐、肾功能异常为主，差异有统计学意义。结论培美曲赛联合奈达铂或者顺铂在晚期肺腺癌一线化疗疗效相似，但毒副反应各有不同，可根据患者不同情况选择合适的治疗方案。

Objective To evaluate the efficacy and adverse reactions of pemetrexed combined with nedaplatin or cisplatin in patients with advanced pulmonary adenocarcinoma. Methods From June 2008 to June 2013, 72 patients with pulmonary adenocarcinoma histopathology-confirmed were devided into the research group and the control group. The two groups were given pemetrexed with 500 mg/m2 intravenously, d1, nedaplatin was performed with 80 mg/m2 in the research group the next day, and cisplatin was performed with the same dose in the control group, the efficacy was evaluated after 2 cycles. Results For the nedaplatin group, objective response rate （ORR） was 51.5, disease control rate （DCR） was 63.6%, and In the cisplatin group, ORR was 53.8, DCR was 71.8%. There was no statistical significance （P〉0.05）. Furthermore, the most common toxicities in the nedaplatin group were neutropenia and thrombocytopenia, whereas those in the cisplatin group were nausea and vomiting, a normal renal function. Conclusion The efficacy was similar in the 2 groups, but the side effect was different, we can choose the appropriate individual patient treatment.