培美曲塞二钠/吉西他滨联合顺铂治疗对非小细胞肺癌的安全性及疗效分析

Comparison of Clinical Efficacy and Safety between Pemetrexed Disodium and Gemcitabine Combined with Cisplatin for the Treatment of Patients with Nonsmall Cell Lung Cancer

目的培美曲塞二钠联合顺铂与吉西他滨联合顺铂治疗非小细胞肺癌(NSCLC)的临床疗效及用药安全性的观察对比,为NSCLC的化疗药物选择提供参考。方法选择本院于2010年1月至2013年7月期间收治的143例NSCLC患者为研究对象,按治疗方式的不同分为观察组(n=77)和对照组(n=66)。观察组患者采用培美曲塞二钠联合顺铂进行治疗,对照组采用吉西他滨联合顺铂进行治疗。对两组患者的治疗效果及用药安全性进行比较。结果观察组完全缓解0例,部分缓解35例(45.5%),稳定31例(40.3%),进展11例(14.3%),总有效率为45.5%,临床获益率为85.8%。对照组完全缓解0例,部分缓解25例(37.9%),稳定32例(48.5%),进展9例(13.6%),总有效率为37.9%,临床获益率为86.4%。两组临床疗效比较,差异无统计学意义(P>0.05)。观察组患者发生毒副反应总次数为98次。Ⅲ度及以上毒副反应28次,其中骨髓抑制13次,胃肠道反应10次,生化学毒性5次;对照组患者发生毒副反应总次数为143次,Ⅲ度及以上反应64次,其中骨髓抑制31次,胃肠道反应21次,生化学毒性12次;观察组毒副反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论培美曲塞二钠联合顺铂治疗NSCLC可获得更好的治疗效果,且毒副作用更低,安全性更好,是临床治疗NSCLC比较理想的选择。

Objective The clinical curative effect and safety between pemetrexed disodium and gemcitabine plus cisplatin for treatment of non-small cell lung cancer （NSCLC） patients were observed and compared to provide reference for chemotherapy of non-small cell lung cancer. Methods 63 patients with NSCLC admitted to our hospital between January 2010 and July 2013 were selected as the subjects of this study. The patients were divided into the observation group （n=37） and the control group （n=26） according to the different treatment methods. The observation group was treated with pemetrexed disodium combined with cisplatin, while the control group was treated with gemcitabine combined with cisplatin. The clinical efficacy and medication safety of the two groups were statistically compared. Results In the observation group, 35 patients were partial remission, accounting for 45.5%, and 31 patients stable, accounting for 40.3%, and 11 patients progressed, accounting for 14.3%. There were no complete recovery patients in the observation group. The total effective rate was 45.5%, and the clini-cal gain rate was 85.8%. In the control group, 25 patients showed partial remission, accounting for 37.9%, 32 patients stable, accounting for 48.5%, and 9 patients progressed, accounting for 13.6%, yet no complete recovery patients. The total effective rate was 37.9%, and the clinical gain rate was 86.4%. The total number of adverse reactions of patients in the observation group was 98 times, third degree and above toxicity 28 times, including bone marrow suppression13 times, gastrointestinal reaction 10 times, and biochemical toxicity 5 times. The total number of adverse reactions of patients in the control group was 143 times, third degree and above toxicity 64 times, including bone marrow suppression 31 times, gastrointestinal reaction 21 times, biochemistry toxicity 12 times. The incidence of adverse reactions in the observation group was significantly lower than in the control group （P〈0.05）. Conclusion For advanced NSCLC chemotherapy, pemetrexed disodium combined with cisplatin treatment can achieve better therapeutic effect. It also achieves less toxic side effects and good medication safety, so it is a good choice for the clinical treatment of patients with NSCLC.