培美曲塞联合顺铂治疗晚期尿路上皮癌临床效果观察

Clinical efficacy of Pemetrexed combined with Cisplatin in treatment of advance urthelial carcinoma

目的探讨培美曲塞联合顺铂治疗晚期尿路上皮癌临床效果及对患者生存率的影响。方法选取2012年3月—2015年7月郑州市第三人民医院78例晚期尿路上皮癌患者,根据化疗方案分组各39例。对照组给予紫杉醇联合顺铂治疗,观察组给予培美曲塞联合顺铂治疗。对比两组临床疗效及不良反应发生率,随访1年,统计两组6个月生存率及1年生存率。结果观察组治疗总有效率41.03%、疾病控制率76.92%与对照组治疗总有效率43.59%、疾病控制率74.36%比较,差异无统计学意义(P>0.05);观察组骨髓抑制及脱发发生率与对照组比较,差异无统计学意义(P>0.05),周围神经病变、胃肠道反应、肌肉关节疼痛及过敏发生率均低于对照组,差异有统计学意义(P<0.05);观察组6个月生存率53.84%、1年生存率38.46%与对照组6个月生存率48.72%、1年生存率35.90%比较,差异无统计学意义(P>0.05)。结论培美曲塞联合顺铂方案治疗晚期尿路上皮癌,临床效果确切,具有较高安全性。

Objective To investigate the clinical efficacy of pemetrexed combined with cisplatin in the treatment of advanced urothelial carcinoma and its effect on the survival rate of the patients. Methods From March 2012 to July2015,78 patients with advanced urothelial carcinoma in Zhengzhou the 3rd People＇s Hospital of were divided into two groups according to the chemotherapy regimen,and each group had 39 cases. The control group was treated with paclitaxel combined with cisplatin,while the observation group was treated with pemetrexed combined with cisplatin. The clinical efficacy and adverse reactions were compared between the two groups. The patients were followed up for 1 years. The survival rate and the survival rate of the patients in the two groups were compared between the 6 groups. Results the total efficiency of the observation group 41. 03%（ 16/39）,disease control rate was 76. 92%（ 30/39） and the control group total effective rate 43. 59%（ 17/39）,disease control rate was 74. 36%（ 29/39）,there was no statistically significant difference（ P 〉0. 05）; the observation group myelosuppression and alopecia was compared with the control group,the difference no statistical significance（ P 〉0. 05）,peripheral neuropathy,gastrointestinal reaction,muscle and joint pain and allergy incidence rates were lower than the control group,the difference was statistically significant（ P 〉0. 05）; The observation group 6 months survival rate was 53. 84%（ 21/39）,1 year survival rate was 38. 46%（ 15/39） and the control group of 6 the 48. 72% month survival rate（ 19/39）,the 1 year survival rate was 35. 90%（ 14/39）,there was no statistically significant difference（ P 〉0. 05）. Conclusion Pemetrexed combined with cisplatin in the treatment of advanced urothelial cancer,the clinical effect is exact,adverse reaction rate is low,with high safety.