培美曲塞联合卡铂与紫杉醇联合卡铂治疗晚期非鳞状非小细胞肺癌的疗效观察

Efficacy of pemetrexed combined with carboplatin versus paclitaxel combined with carboplatin for advanced non-squamous non-small cell lung cancer

目的探讨培美曲塞联合卡帕与紫杉醇联合卡帕一线化疗治疗晚期非鳞状非小细胞肺癌(NSCLC)的疗效和安全性。方法选取2018年1月至2019年12月间辽阳市中心医院收治的166非鳞NSCLC患者,采用随机数字表法分为培美曲塞组和紫杉醇组,每组83例。培美曲塞组患者采用培美曲塞联合卡帕化疗治疗,紫杉醇组患者采用紫杉醇(每周)联合卡帕化疗治疗,比较两组患者6个月无进展生存率(PFS)、客观缓解率(ORR)、疾病控制率(DCR)、总生存率(OS)和不良反应分度。结果两组患者中位PFS和OS比较,差异均无统计学意义(均P>0.05)。紫杉醇组患者ORR为30.1%,高于培美曲塞组的15.7%,差异有统计学意义(P<0.05);紫杉醇组患者DCR率高于培美曲塞组,但差异无统计学意义(P>0.05)。紫杉醇组患者脱发、周围神经病变和肌痛发生率均高于培美曲塞组,差异均有统计学意义(均P<0.05)。结论培美曲塞联合卡帕和紫杉醇(每周)联合卡帕方案治疗非鳞状NSCLC患者的DCR和OS无较大差异,紫杉醇(每周)联合卡帕方案可获得更好的ORR,但培美曲塞联合卡帕方案有更好的安全性,临床可根据患者实际情况选择合适方案。

Objective To explore the efficacy and safety of pemetrexed plus carboplatin and paclitaxel plus carboplatin as first-line chemotherapy in the treatment of advanced non-squamous non-small cell lung cancer(NSCLC). Methods A total of 166 non-squamous NSCLC patients were selected at Liaoyang Central Hospital from January 2018 to December 2019. The patients were divided into a pemetrexed group and a paclitaxel group with 83 each by random number table method. The pemetrexed group was given pemetrexed plus carboplatin and the paclitaxel was given paclitaxel(weekly) plus carboplatin. The 6-month progression-free survival(PFS), objective remission rate(ORR), disease control rate(DCR), overall survival(OS) and adverse reactions were compared between the two groups. Results There was no significant difference in the median PFS and OS between the two groups(P>0.05). The ORR was 30.1% in the paclitaxel group which was higher than 15.7% of the pemetrexed group(P<0.05). The DCR rate was higher in the paclitaxel group than in the pemetrexed group(P>0.05). The incidence of alopecia, peripheral neuropathy, and myalgia was higher in the paclitaxel group than in the pemetrexed group(P<0.05). Conclusion There was no significant difference in DCR and OS between pemetrexed plus carboplatin and paclitaxel(weekly) plus carboplatin regimens in the treatment of non-squamous NSCLC. Paclitaxel(weekly)-carboplatin regimens can achieve higher ORR, and pemetrexed-carboplatin regimen has better safety. The appropriate clinical regimen should be selected according to the actual situation of a patient.