培美曲塞、吉西他滨分别联合卡铂治疗非小细胞肺癌患者的疗效比较

Comparison of efficacy of pemetrexed and gemcitabine combined with carboplatin in patients with non-small cell lung cancer

目的比较培美曲塞、吉西他滨分别联合卡铂治疗非小细胞肺癌(NSCLC)患者的疗效。方法选取51例行吉西他滨+卡铂化疗的NSCLC患者作为A组,另选取49例行培美曲塞+卡铂化疗的NSCLC患者作为B组。比较两组患者的疾病控制率、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)19-9、CA72-4]及不良反应发生情况。结果两组患者的疾病控制率比较,差异无统计学意义(P﹥0.05);治疗后,两组患者血清CEA、CA19-9、CA72-4水平均低于本组治疗前,B组患者血清CEA、CA19-9、CA72-4水平均低于A组,差异均有统计学意义(P﹤0.05)。B组患者胃肠道反应、血小板计数减少发生率均低于A组,差异均有统计学意义(P﹤0.05)。结论吉西他滨、培美曲塞分别联合卡铂治疗NSCLC患者的疗效基本相同,培美曲塞+卡铂可进一步降低血清肿瘤标志物水平,安全性更高,建议临床可结合患者实际情况选择不同的化疗方案。

Objective To compare the efficacy of pemetrexed and gemcitabine combined with carboplatin in patients with non-small cell lung cancer(NSCLC).Method A total of 51 patients with NSCLC who received gemcitabine+carboplatin chemotherapy were selected as group A,and 49 patients with NSCLC who received pemetrexed+carboplatin chemotherapy were selected as group B.The disease control rate,serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4]and incidence of adverse reactions were compared between the two groups.Result There was no significant difference in disease control rate between the two groups(P>0.05).After treatment,the serum CEA,CA19-9 and CA72-4 levels in two groups were lower than those before treatment,the serum CEA,CA19-9 and CA72-4 levels in group B were lower than those in group A,and the differences were statistically significant(P<0.05).The incidences of gastrointestinal reaction and decreased platelet count in group B were lower than those in group A,and the differences were statistically significant(P<0.05).Conclusion Gemcitabine and pemetrexed combined with carboplatin in the treatment of NSCLC patients have basically the same efficacy,and pemetrexed+carboplatin can further reduce the levels of serum tumor markers and has higher safety.It is suggested that different chemotherapy regimens can be selected according to the actual situation of patients in clinical practice.