不同化疗方案治疗晚期非小细胞肺癌临床观察

Clinical Observation of Different Chemotherapy Regimens in the Treatment of Advanced Non-small Cell Lung Cancer

目的探讨不同化疗方案治疗晚期非小细胞肺癌的临床疗效和不良反应。方法 90例晚期非小细胞肺癌患者均分为2组,观察组45例患者给予培美曲塞联合顺铂方案化疗,对照组45例患者给予吉西他滨联合顺铂方案化疗,比较观察2组的近期疗效、治疗前后血清肿瘤标志物水平及不良反应。结果观察组治疗有效率(68.89%)高于对照组(46.67%),差异有统计学意义(P<0.05)。治疗前2组患者癌胚抗原(CEA)、癌抗原125(CA125)、神经元异性烯醇化酶(NSE)、细胞角质素片断抗原(Cyfra21-1)等血清肿瘤标志物水平比较差异均无统计学意义(P均>0.05);治疗后2组患者CEA、CA125、NSE、Cyfra21-1均改善,观察组优于对照组,差异均有统计学意义(P均<0.05)。2组患者化疗均存在一定不良反应,主要表现为骨髓抑制、胃肠道反应、静脉炎、脱发等,程度较轻,患者身体可耐受,2组发生率比较差异均无统计意义(P均>0.05)。结论晚期非小细胞肺癌采取化疗治疗效果良好,临床化疗方案较多,并无统一治疗标准,其中培美曲塞联合顺铂化疗近期疗效佳,血清肿瘤标志物改善明显,且安全性较好,值得临床推广。

Objective To explore the clinical efficacy and toxicities of different chemotherapy regimens in the treatment of advanced non-small cell lung cancer. Methods Ninty patients with advanced non-small cell lung cancer were divided into two groups. The 45 patients in the observation group received the pemetrexed combined with cisplatin chemotherapy,and the 45 patients in the control group received gemcitabine combined with cisplatin chemotherapy,the clinical efficacy,levels of tumor markers,toxicities were compared between the two groups. Results The effective rate in the observation group（68. 89%） was higher than that in the control group（46. 67%,P〈0.05）. The levels of serum cancer embryonal antigen（ CEA）,cancer antigen 125（ CA125）,neuron specific enolase（ NSE） and cytokeratin fragment antigen（ Cyfra21-1） were equal in the two groups before the treatment（ P〉0.05）;the levels of CEA,CA125,NSE and Cyfra21-1 were changed in the two groups after treatment,those in the observation group were better than the control group（ P〈0.05）. All the patients in the two groups had some adverse reactions,included bone marrow suppression,gastrointestinal reaction,phlebitis,hair loss and so on,the degree were mild,the toxicity incidences were equal in the two groups（ P〉0.05）. Conclusion The effect of chemotherapy for advanced non-small cell lung cancer is good,there are many clinical chemotherapy schemes,there is no unified standard of treatment. Pemetrexed combined with cisplatin chemotherapy has good curative effect,the patient＇s condition is improved,the rate of adverse reaction can be relieved and the safety is high,so it can be popularized and applied.