培美曲塞或吉西他滨联合卡铂治疗晚期非小细胞肺癌的临床疗效及安全性评价

Clinical efficacy and safety of pemetrexed or gemcitabine combined with carboplatin in the treatment of advanced non-small cell lung cancer

目的评价培美曲塞或吉西他滨联合卡铂治疗晚期非小细胞肺癌的临床疗效及安全性。方法将80例晚期非小细胞肺癌患者随机分为A组39例和B组41例。A组予以培美曲塞500 mg·m-2静脉滴注,第1天＋卡铂5 mg·m L-1·min-1静脉滴注,第1天。B组予以吉西他滨1000 mg·m-2静脉滴注,第1,8天＋卡铂5 mg·m L-1·min-1静脉滴注,第1天。2组患者1个周期均为21 d,共化疗4~6个周期。比较2组患者的客观有效率、疾病控制率、中位无进展生存期及不良反应发生情况。结果 A组客观有效率、疾病控制率及中位无进展生存期分别为33.33%、69.23%及5.8个月,B组分别为36.59%、63.41%及5.5个月,差异均无统计学意义（P〉0.05）。A组发生Ⅲ~Ⅳ级消化道反应5例（12.8%）,骨髓抑制4例（10.3%）;B组发生Ⅲ~Ⅳ级消化道反应4例（9.8%）,骨髓抑制13例（31.7%）,B组Ⅲ~Ⅳ级骨髓抑制发生率显著高于A组（P〈0.05）。结论培美曲塞联合卡铂与吉西他滨联合卡铂治疗晚期非小细胞肺癌患者的临床疗效相当,但前者不良反应发生率相对较低。

Objective To discuss the clinical curative effect and toxicity of pemetrexed or gemcitabine combined with carboplatin in the treatment of advanced non-small cell lung cancer（NSCLC）.Methods Eighty patients with advance NSCLC were included in this study and randomly divided into group A and B with 39 and 41 cases in each group.Pemetrexed 500 mg · m-2intervenous drop infusion day 1,carboplatin5 mg·m L-1·min-1intervenous drop infusion day 1 was administered in group A and gemcitabine 1000 mg·m-2intervenous drop infusion day1,8 carboplatin 5 mg · m L-1·min-1intervenous drop infusion day 1with 21 days per cycle for 4-6 cycles.The objective response rate（ORR） and disease control rate（DCR）,progression free survival（PFS）and toxicity between group A and group B were compared.Results The ORR,DCR,PFS were 33.33%,69.23%,5.8 months in group A and 36.59%,63.41% 5.5 months in group B with no difference between the two groups（P 〉 0.05）.The grade Ⅲ-Ⅳdigestive tract reaction and bone marrow suppression were 12.8%,10.3% in group A and 9.8%,31.7% in group B.The grade Ⅲ-Ⅳbone marrow suppression risk was significant higher in group B thangroup A.Conclusion The clinical effects was the same for pemetrexed or gemcitabine combined with carboplatin in the treatment of advanced non-small cell lung cancer,but the toxicity in pemetrexed group was less than gemcitabine group.