洛铂或顺铂联合培美曲塞治疗晚期肺腺癌临床观察

Clinical observation of lobaplatin or cisplatin combined with pemetrexeddisodium in the treatment of advanced ade-nocarcinoma of lung

目的：探讨洛铂或顺铂联合培美曲塞治疗晚期肺腺癌的疗效及不良反应。方法将73例晚期肺腺癌患者按随机数字表法分成两组，其中洛铂组39例患者接受洛铂联合培美曲塞方案化疗，即培美曲塞500 mg/m2静脉滴注，第1天；洛铂30 mg/m2静脉滴注，第1天。3周为1个周期。顺铂组34例患者接受顺铂联合培美曲塞方案化疗，即培美曲塞500 mg/m2静脉滴注，第1天；顺铂25 mg/m2静脉滴注，第1~3天。两组患者均接受至少2个周期的化疗，比较两组疗效及不良反应发生情况。结果洛铂组总有效率为56.4%（22/39），顺铂组为58.8%（20/34），两组比较差异无统计学意义（P﹥0.05）。洛铂组Ⅲ~Ⅵ度血小板减少发生率（7例，17.9%）高于顺铂组（4例，11.8%），但差异无统计学意义（P﹥0.05）。肾毒性、神经毒性发生率两组比较差异无统计学意义（P﹥0.05）。洛铂组无Ⅲ~Ⅵ度胃肠道反应，明显低于顺铂组（5例，14.7%），差异有统计学意义（P﹤0.05）。结论洛铂或顺铂联合培美曲塞都是治疗晚期肺腺癌的有效方案，两者疗效相似，但洛铂胃肠道反应发生率低于顺铂，安全耐受性好。

Objective To investigate the efficacy and toxicity of lobaplatin or cisplatin combined with pemetrexeddisodium for patients with advanced adenocarcinoma of lung. Methods Seventy-three patients with late stage lung adenocarcinoma were randomly divided into two groups. The 39 patients in LP regimen group recieved lobaplatin 30 mg/m2 ,iv,d1;pemetrexed disodium 500 mg/m2 ,iv,d1. Three weeks were a cycle. The 34 patients in CP regimen group recieved cisplatin 25 mg/m2 ,iv,d1-3;peme-trexed disodium 500 mg/m2 ,iv,d1,Three weeks were a cycle. The efficacy and toxicity were evaluated after at least two cycles of chemotherapy. Results The response rate（ RR）in LP regimen group was 56. 4%（22/39）,while that in CP regimen group was 58. 8%（20/34）,there was no significant difference between the two groups（P﹥0. 05）. Grade 3-4 thrombocytopenia rate in LP regimen group（17. 9%,7/39）was higher than that in CP regimen group（11. 8%,4/34）,but there was no significant difference be-tween the two groups（P﹥0. 05）. There was no difference in nephrotoxicity and neurotoxicity between the two groups（P﹥0. 05）. In LP regimen group,the incidence of grade 3 -4 gastrointestinal reaction was 0. 0%（0/39）,and was 14. 7%（5/34）in CP regimen group,there was significant difference between the two groups（ P﹤0. 05 ）. Conclusions Both LP and CP are safe and effective chemotherapy for patients with advanced lung adenocarcinoma. The effectiveness of lobaplatin with pemetrexeddisodium is similar to that of cisplatin with pemetrexeddisodium in initial treatment of advanced adenocarcinoma of lung,but lobaplatin causes less gastrointestinal reaction. Lobaplatin is well tolerant and has less toxicity.