培美曲塞联合顺铂不同途径治疗晚期非小细胞肺癌疗效观察

Efficacy of Pemetrexed Combined with Cisplatin Administrated by Different Routes in the Treatment of Advanced Non-small Cell Lung Cancer

目的:研究培美曲塞联合顺铂不同给药途径治疗晚期非小细胞肺癌并发恶性胸腔积液的临床疗效与不良反应,为晚期非小细胞肺癌的临床治疗提供参考。方法:老年晚期非小细胞肺癌并发恶性胸腔积液患者48例随机分为培美曲塞联合顺铂静脉滴注组(Ⅳ组)和培美曲塞联合顺铂胸腔灌注组(IP组)。采用不同途径给药,评价比较两组疗效与药品不良反应。结果:两组患者疗效比较,差异无统计学意义(P>0.05);IP组生活质量改善率明显高于IV组(P<0.05),Ⅳ组的不良反应发生率明显高于IP组(P<0.05)。结论:培美曲塞联合顺铂胸腔灌注治疗与全身化疗治疗晚期非小细胞肺癌并发恶性胸腔积液疗效相当,但胸腔灌注治疗较全身化疗治疗具有更好的安全性和耐受性。

Objective： To study the efficacy and adverse reactions of pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer to provide evidence for the clinical treatment of the cancer. Methods ： Totally 48 elder non-small cell hmg cancer patients complicated with malignant pleural effusion were selected and randomly divided into pemetrexed combined with cisplatin infusion group （Ⅳ group） and pemetrexed combined with cisplatin intrapleural infusion group （IP group）. The efficacy and adverse reactions of the two groups were evaluated. Results： The difference in response between the two groups were not statistically significant （ P 〉 0.05 ）. Compared with that of IV group, the improvement rate of IP group was much higher （ P 〈 0.05 ）. The occurrence of adverse reactions in IV group was higher than that in IP group （P 〈 0.05 ）. Conclusion： Pemetrexed combined with cisplatin intra- pleural infusion therapy and the systemic chemotherapy in the treatment of advanced non-small cell lung cancer complicated with malignant pleural effusion has therapeutic equivalence, while the intrapleural infusion therapy shows better safety and tolerability than the chemotherapy.