培美曲塞和吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床效果对比观察

Clinical effect of pemetrexed and gemcitabine combined with carboplatin in the treatment of elderly patients with advanced non-small cell lung cancer

目的：评价培美曲塞和吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床效果，探讨其临床适用性和优越性。方法选择从2013年6月~2015年12月于我院就诊的84例晚期非小细胞肺癌患者作为试验组，另选择从2011年6月~2013年12月的60例患者作为对照组，对照组采用吉西他滨联合卡铂的化疗方案，试验组则采用培美曲塞联合卡铂化疗方案。观察两组患者的化疗疗效及药物对血液毒性的影响。结果试验组患者的有效率为52.38%，对照组53.33%，两组比较差异无统计学意义（χ2=0.0127，P＞0.05）；试验组患者的疾病控制率为88.10%，对照组86.67%（χ2=0.0653，P＞0.05）。试验组患者各项血液指标出现异常的情况均低于对照组患者，差异有统计学意义（P＜0.05）。结论培美曲塞联合卡铂在治疗老年晚期非小细胞肺癌方面可以达到和吉西他滨联合卡铂同样的效果，而且血液毒性小，安全性较高，适合临床长期推广应用。

Objective To estimate the clinical effect of pemetrexed and gemcitabine combined with carboplatin in the treatment of elderly patients with advanced non-small cell lung cancer, and explore their clinical usability and superiorities.Methods 84 elderly patients with advanced non-small cell lung cancer who were in our hospital from June 2013 to December 2015 were selected as experimental group, another 60 patients during June 2011 and December 2013 were selected as control group. The control group received chemotherapy of gemcitabine and carboplatin, and the experimental group received chemotherapy of pemetrexed and carboplatin. The chemotherapy efficacy and drugs’ toxicities on blood of the two groups were analyzed and compared.Results The effective rate of the experimental group was 52.38%, while that of the control group was 53.33%, the difference was not statistical significant （χ2=0.0127,P〉0.05）. The disease control rate of the experimental group was 88.10%, while that of the control group was 86.67% （χ2=0.0653,P〉0.05）. The abnormal rate of blood indexes of the experimental group was lower than that of the control group, the difference was statistically significant （P〈0.05）.ConclusionCompared with the therapy of gemcitabine and carboplatin, the chemotherapy of pemetrexed and carboplatin has the same efficacy in the treatment of elderly patients with advanced non-small cell lung cancer, moreover, it has smaller toxicities on blood, thus is safe and suitable for long-term clinical promotion.