培美曲塞和吉西他滨分别联合顺铂治疗晚期肺腺癌近期疗效及毒副反应情况探讨

Observation on Short-term Curative Effect and Side and Toxic Effect of Pemetrexed Combined with Cis-platinum and Gemcitabine Combined with Cis-platinum in Treatment of Advanced Lung Adenocarcinoma

目的对比培美曲塞联合顺铂、吉西他滨联合顺铂2种治疗方案对晚期肺腺癌的近期疗效及不良反应,以指导临床药物选择。方法方便2012年10月—2015年10月该院收治的晚期肺腺癌(ⅢB期及Ⅳ期)患者80例,按治疗方案划分为2组:观察组应用培美曲塞联合顺铂治疗;对照组应用吉西他滨联合顺铂治疗。均化疗2个周期后,评估并对比疗效及毒副反应。结果观察组总缓解率30.0%、总控制率67.5%,对照组总缓解率27.5%、总控制率70.0%,2组近期疗效差异无统计学意义(P>0.05);观察组白细胞下降、血小板下降及脱发发生率分别为12.5%、7.5%、10.0%,明显低于对照组42.5%、37.5%、37.5%,差异有统计学意义(P<0.05),2组其它不良反应发生率差异无统计学意义(P>0.05)。结论培美曲塞联合顺铂治疗晚期肺腺癌可取得与吉西他滨联合顺铂相近的疗效,且其耐受性优于后者,有一定推广价值。

Objective To compare the short-term curative effect and side and toxic effect of pemetrexed combined with cisplatinum and gemcitabine combined with cis-platinum in treatment of advanced lung adenocarcinoma in order to guide clinical drug selection.Methods 80 cases of patients with advanced lung adenocarcinoma（ⅢB stage and Ⅳ stage） admitted and treated in our hospital from October 2012 to October 2015 were divided into two groups according to different treatment programs,the observation group were treated with pemetrexed combined with cis-platinum,the control group were treated with gemcitabine combined with cis-platinum,and the curative effect and side and toxic effect of the two groups were evaluated and compared after 2 weeks of chemotherapy.Results The total remission rate and total control rate were respectively 30.0% and 67.5% in the observation group and 27.5% and 70.0% in the control group,and the difference in the short-term curative effect between the two groups had no statistical significance,P〉0.05;the incidence rates of leukocyte decrease,platelet decrease and alopecia in the observation group were obviously lower than those in the control group,（12.5%,7.5%,10.0% vs 42.5%,37.5%,37.5%）,and the differences had statistical significance,P〈0.05,and the difference in the incidence rate of side and toxic effect between the two groups had no statistical significance,P〉0.05.Conclusion The curative effect of pemetrexed combined with cis-platinum in treatment of advanced lung adenocarcinoma is similar to that of gemcitabine combined with cis-platinum,and the tolerance of it is better than that of the latter,which is of a certain promotion value.