培美曲塞、依托泊苷与顺铂联合胸部放疗对局部晚期肺腺癌患者远近期疗效的影响研究

Study of the Effects of Pemetrexed,Etoposide and Cisplatin Combined with Thoracic Radiotherapy on Long-term and Near-term Outcomes in Patients with Locally Advanced Lung Adenocarcinoma

目的:探讨培美曲塞、依托泊苷与顺铂联合胸部放疗对局部晚期肺腺癌患者远近期疗效的影响。方法:选取2017年5月—2020年5月佳木斯市中心医院收治的76例局部晚期肺腺癌患者作为研究对象,按随机数表法分为对照组和观察组,每组各38例。两组患者均行胸部放疗,对照组患者予以依托泊苷联合顺铂(EP)化疗方案治疗,观察组患者予以培美曲塞联合顺铂(PP)化疗方案治疗。比较化疗2个周期后两组患者临床疗效、血清肿瘤标志物、生存质量及不良反应发生情况,并随访2年,记录远期生存率。结果:观察组患者疾病控制率高于对照组患者,差异有统计学意义(χ^(2)=4.094,P<0.05)。治疗后,观察组患者癌胚抗原(CEA)、糖类抗原125(CA125)及细胞角质素片段抗原21-1(CYFRA21-1)水平均低于对照组患者,差异有统计学意义(t=4.992、4.861、6.715,P<0.05)。治疗后,观察组患者生活质量中生理、心理、环境、社会评分均高于对照组患者,差异有统计学意义(t=4.747、5.004、5.138、4.744,P<0.05)。观察组患者远期生存率高于对照组患者,差异有统计学意义(χ^(2)=4.413,P<0.05)。结论:PP同步胸部放疗可增强局部晚期肺腺癌患者的治疗效果,加快肿瘤标志物水平复常,提高患者远期生存率,改善其生存质量,安全可靠。

Objective:To investigate the effects of pemetrexed,etoposide and cisplatin combined with thoracic radiotherapy on the long-term and near-term outcomes in patients with locally advanced lung adenocarcinoma.Methods:76 cases of locally advanced lung adenocarcinoma patients admitted to the hospital from May 2017 to May 2020 were selected as the study subjects,and were divided into the control group and the observation group according to the method of random number table,with 38 cases in each group.Both groups were treated with chest radiotherapy,the control group was treated with etoposide combined with cisplatin(EP)chemotherapy regimen,and the observation group was treated with pemetrexed combined with cisplatin(PP)chemotherapy regimen.The clinical efficacy,serum tumor markers,survival quality and the occurrence of adverse reactions were compared between the two groups after 2 cycles of chemotherapy,and the long-term survival rate was recorded after 2 years of follow-up.Results:The disease control rate of the observation group was higher than that of the control group,and the difference was statistically significant(χ^(2)=4.094,P<0.05).After treatment,the levels of CEA,CA125,and CYFRA21-1 in the observation group were lower than those in the control group,and the difference was statistically significant(t=4.992,4.861,6.715;P<0.05).After treatment,the physical,psychological,environmental,and social scores in the quality of life of the observation group were higher than those of the control group,and the difference was statistically significant(t=4.747,5.004,5.138,4.744;P<0.05).The long-term survival rate of the observation group was higher than that of the control group,and the difference was statistically significant(χ^(2)=4.413,P<0.05).There was no statistically significant difference in the incidence rate of adverse reaction group between the two groups of patients(χ^(2)=0.517,P>0.05).Conclusion:PP combined with cisplatin simultaneous chest radiotherapy can enhance the therapeutic efficacy of patients with locally advanced lung adenocarcinoma,accelerate the normalization of tumor marker levels,increase the long-term survival rate of patients,and improve their quality of life.It is safe and reliable.