培美曲塞注射剂与多西他赛注射剂治疗非小细胞肺癌患者的临床研究

Pemetrexed versus docetaxel in non-small cell lung cancer

目的观察培美曲塞和多西他赛分别联合顺铂治疗非小细胞肺癌(NSCLC)的临床疗效和安全性。方法将60例NSCLC患者的临床资料,据化疗方案的不同分为试验组(n=33)和对照组(n=27)。对照组第1天予以静脉滴注多西他赛75 mg·m-2,第1~3天予以静脉滴注顺铂25 mg·m-2;试验组第1天予以静脉滴注培美曲塞500 mg·m-2,第1~3天予以静脉滴注顺铂25mg·m-2;2组均以21 d为1个周期,各化疗周期间隔1周,连续化疗2个周期。比较2组化疗后的临床疗效,硫氧还原蛋白结合蛋白(TXNIP)表达,以及药物不良反应。结果试验组和对照组中位无进展生存时间分别为7.2和4.9个月,差异有统计学意义(P <0.05)。试验组和对照组肺组织中TXNIP相对表达量分别为1.12±0.01,0.32±0.01,差异有统计学意义(P <0.01)。试验组和对照组的药物不良反应均以白细胞减少、血红蛋白减少、血小板减少、恶心呕吐、皮疹和肝功能损伤为主,差异均有统计学意义(均P <0.05)。结论培美曲塞联合顺铂比多西他赛联合顺铂治疗NSCLC的疗效更佳,安全性较高。

Objective To investigate the clinical efficacy and safety profile of pemetrexed/docetaxel in combination with cisplatin neoadjuvant chemotherapy in non-small cell lung cancer(NSCLC)patients.Methods A total of 60 patients with NSCLC were assigned to treatment group(n=33)and control group(n=27)according to different chemotherapy regimens.Control group received intravenous drip of docetaxel(75 mg·m-2,Day 1)combined with cisplatin(25 mg·m-2,Day 1-3);Treatment group received intravenous drip of pemetrexed(500 mg·m-2,Day 1)combined with cisplatin(25 mg·m-2,Day 1-3);Both groups were treated for 2 cycles(a cycle=21 days,with 1 week interval between each chemotherapy cycle).The clinical efficacy,expression of thioredoxin binding protein(TXNIP)and adverse drug reactions were compared between 2 groups.Results The median progression-free survival time were 7.2 months and 4.9 months in treatment group and control group,respectively,with significant difference(P<0.05).There were statistically significant differences in the relative expression of TXNIP between the lung tissue of treatment group and control group(1.12±0.01 vs 0.32±0.01)(P<0.01).There were statistically significance between the two groups in main adverse drug reactions,including eucopenia,hemoglobin reduction,thrombocytopenia,nausea and vomiting,rash,and liver function damage(P<0.05).Conclusion Pemetrexed in combination with cisplatin exerted considerable clinical efficacy and safety profile in the treatment of NSCLC by increasing the expression of TXNIP in lung tissue.