培美曲塞与依托泊苷分别联合顺铂治疗局部晚期非鳞非小细胞肺癌的疗效观察

Efficacy of pemetrexed and etoposide combined with cisplatin in treatment of locally advanced non squamous non-small cell lung cancer

目的探讨培美曲塞联合顺铂与依托泊苷联合顺铂在胸部同期放化疗中治疗局部晚期非鳞非小细胞肺癌患者的临床疗效比较。方法选取2013年9月至2015年12月间广州市番禺区中心医院收治的60例同期放化疗治疗的局部晚期非鳞非小细胞肺癌患者,采用随机数字表法分为培美曲塞联合顺铂组(AP组)31例和依托泊苷联合顺铂组(EP组)29例。两组患者同时接受胸部同步放化疗,对比两组患者客观有效率、疾病控制率及毒性反应的差异。结果 AP组客观有效率为67.7%,高于EP组的37.9%,差异有统计学意义(P<0.05);两组患者疾病控制率比较,差异无统计学意义(P>0.05)。AP组3/4级毒性反应率为41.9%(13/31),低于EP组的65.5%(19/29),差异有统计学意义(P<0.05);AP组3/4级粒细胞减少发生率为22.6%(7/31),低于EP组的55.2%(16/29),差异有统计学意义(P<0.05)。AP组不良反应发生率为9.7%,低于EP组的44.8%,差异有统计学意义(P<0.05)。结论培美曲塞联合顺铂方案较依托泊苷联合顺铂方案在同期放化疗中治疗晚期非鳞非小细胞肺癌,客观有效率高,疾病控制率相似,毒性反应及不良反应均减少,能否提高生存时间还有待进一步观察。

Objective To compare concurrent chemotherapy of pemetrexed-cisplatin versus etoposide-cisplatin in the treatment of locally advanced non squamous non small cell lung cancer（NSNSCLC）.Methods A total of 60 NSNSCLC patients treated at Guangzhou Panyu District Central Hospital from September 2013 to December 2015 were selected. Using a random number table,patients were divided into pemetrexed plus cisplatin group（AP group,31 patients） and etoposide plus cisplatin group（EP group,29patients）. Both groups were simultaneously treated with concurrent thoracic chemoradiotherapy and objective efficiency,disease control rate and toxicity reaction were compared between the two groups. Results The objective efficiency in AP group（67. 7%） was higher than in EP group（37. 9%）（P〈0. 05）. There was no significant difference in disease control rate between the two groups（P〈0. 05）. The grade 3/4 toxicity reaction rate was 41. 9%（13/31） in AP group which was lower than 65. 5%（19/29） of EP group（P〈0. 05）. The incidence of grade 3/4 granulopenia was 22. 6%（7/31） in AP group,which was lower than55. 2%（16/29） of EP group（P〈0. 05）. The incidence of adverse reactions in AP group（9. 7%） was lower than in EP group（44. 8%）（P〈0. 05）. Conclusion The efficiency of concurrent chemotherapy of pemetrexed combined with cisplatin is significantly improved compared with etoposide combined with cisplatin in the treatment of locally advanced non squamous non small cell lung cancer with similar disease control rate and less toxicity and adverse reactions but whether it can improve survival remains to be researched.