培美曲塞联合顺铂方案化疗后行培美曲塞同药维持治疗在晚期肺腺癌患者中的应用

Application of pemetrexed combined with cisplatin chemotherapy with pemetrexed and maintenance therapy in patients with advanced lung adenocarcinoma

目的探讨培美曲塞联合顺铂方案化疗后进行培美曲塞同药维持治疗在晚期肺腺癌患者中的应用。方法选取2015年7月~2016年7月间我院收取的ⅢB~Ⅳ期肺腺癌患者80例,按照随机数字表法分为实验组和对照组,每组40例。所有的患者均已经过4个周期的培美曲塞联合顺铂方案化疗且病情已得到控制。两组患者均给予缓解肿瘤相关症状支持治疗及最佳关怀治疗。在此基础上,实验组患者予以培美曲塞维持治疗;对照组则在两药联合化疗后不进行任何抗肿瘤操作。治疗8个周期后,观察两组患者的客观缓解率、疾病控制率及不良反应发生情况。两组均治疗至出现不能耐受的不良反应或疾病进展或随访至48周满,治疗结束后对比两组患者的无进展生存期(PFS)。结果实验组的客观缓解率为35%,疾病控制率为87.5%,对照组分别为5%、17.5%,两组客观缓解率、疾病控制率比较,差异有统计学意义(P<0.05)。对照组的PFS为(2.50±1.04)个月,实验组为(5.60±1.18)个月,差异有统计学意义(P<0.05);两组患者口腔黏膜反应、重度白细胞减少、皮疹、重度血小板减少、恶心、呕吐等不良反应发生率差异无统计学意义(P>0.05)。结论培美曲塞联合顺铂方案化疗后进行培美曲塞同药维持治疗能够控制晚期肺腺癌患者病情进展,延长PFS。

Objective To investigate the application of pemetrexed combined with cisplatin chemotherapy with pemetrexed and maintenance therapy in patients with advanced lung adenocarcinoma.Methods From July2015to July2016,80patients with stageⅢB toⅣlung adenocarcinoma were selected and divided into experimental group and control group according to random number table method,with40cases in each group.All patients had undergone4cycles of pemetrexed combined with cisplatin chemotherapy and the condition had been controlled.Two groups of patients were given support therapy and best care for relieving tumor related symptoms.On this basis,the experimental group patients were given pemetrexed maintenance treatment;In the control group,no anti-tumor operation was performed after combined chemotherapy.After8cycles of treatment,the objective remission rate,the rate of disease control and the incidence of adverse reactions were observed in the two groups.The two groups were treated with intolerant adverse reactions or disease progression or follow-up to48weeks.The progression free survival(PFS)of the two groups was compared after the end of the treatment.Results The objective remission rate of the experimental group was35%,the rate of disease control was87.5%,and the control group was5%and17.5%,respectively.The objective remission rate and disease control rate of the two groups were compared,the difference was statistically significant(P<0.05).The PFS in the control group was(2.5±1.04)months,and the experimental group was(5.6±1.18)months,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of oral mucosal reaction,severe leukocyte reduction,rash,severe thrombocytopenia,nausea and vomiting between the two groups(P>0.05).Conclusion Pemetrexed combined with cisplatin chemotherapy with pemetrexed and maintenance therapy can control the progression of patients with advanced lung adenocarcinoma,and prolong PFS.