培美曲塞与雷替曲塞联合顺铂治疗恶性胸膜间皮瘤的疗效与安全性

Efficacy and safety of pemetrexed or raltitrexed combined with cisplatin in treatment of malignant pleural mesothelioma

目的探讨培美曲塞联合顺铂与雷替曲塞联合顺铂治疗恶性胸膜间皮瘤的疗效和安全性。方法回顾性分析64例恶性胸膜间皮瘤患者的临床资料,采用培美曲塞联合顺铂化疗的纳入PP组(32例),采用雷替曲塞联合顺铂方案的为RP组(32例),比较两组不同化疗方案的疗效及不良反应。结果两组患者客观有效率、疾病控制率比较,差异均无统计学意义(χ2分别=2.35、3.76,P均>0.05)。PP组患者中位总生存期为11.62个月,中位无疾病进展生存期为5.61个月;RP组患者中位总生存期为11.33个月,中位无疾病进展生存期为4.93个月,两组患者在中位总生存期、中位无疾病进展生存期之间的差异均无统计学意义(t分别=1.06、2.08,P均>0.05)。两组患者不良反应均以骨髓抑制和胃肠道反应为主,两组之间不良反应比较,差异无统计学意义(χ2=2.82,P>0.05)。结论培美曲塞或雷替曲塞联合顺铂用于MPM的临床疗效相当,对于经济条件较差的MPM患者来说,选用雷替曲塞联合顺铂治疗也可以作为MPM的一线方案。

Objective To evaluate the efficacy and safety of pemetrexed or raltitrexed combined with cisplatin in treatment of malignant pleural mesothelioma. Methods The clinical data of 64 patients with MPM were retrospectively analyzed and divided into PP group which received pemetrexed combined with cisplatin and RP group which received raltitrexed combined with cisplatin. The efficacy and adverse reactions between two groups were compared. Results No statistical difference was found in the objective response rate and the disease control rate（χ2=2.35, 3.67,P〈0.05）. No statistical difference was found in median overall survival（11.62 months vs 11.33 months） and median progression-free survival（5.61 months vs 4.93 months） between the two groups（t=1.06,2.08,P〉0.05）. The adverse reactions in the two groups focus on myelosuppression and gastrointestinal reaction, but no statistical difference in the adverse reactions was found between the two groups（χ2=2.82,P〉0.05）. Conclusion The clinical efficacy of the two treatment regimens as first-line chemotherapy for MPM is similar. Raltitrexed combined with cisplatin is a preferred treatment regimen for patients whose family cannot afford pemetrexed.