培美曲塞联合顺铂治疗晚期非小细胞肺癌的疗效观察

Clinical Observation of Pemetrexed and Cisplatin in the Treatment of Advanced Non-small Cell Lung Cancer

目的探讨培美曲塞联合顺铂治疗晚期非小细胞肺癌的疗效和安全性。方法将92例晚期非小细胞肺癌患者随机分入培美曲塞组及吉西他滨组,2组患者分别接受培美曲塞或吉西他滨联合顺铂治疗。比较2组患者1年及2年生存率、近期疗效、中位生存时间及不良反应发生率。结果培美曲塞组1年及2年生存率分别为64.2%和35.7%,吉西他滨组分别为61.9%和31.0%,差异无统计学意义(P>0.05);2组中位生存时间分别为16.8个月和17.1个月(P>0.05)。吉西他滨组与培美曲塞组治疗有效率分别为80.9%和83.3%,总缓解率分别为45.2%和42.9%(P>0.05);培美曲塞组患者Ⅲ~Ⅳ级骨髓抑制发生率显著低于吉西他滨组(11.9%vs 45.2%,P<0.05);治疗后培美曲塞组患者KPS评分显著优于吉西他滨组(P<0.05)。结论培美曲塞与吉西他滨分别联合顺铂治疗晚期非小细胞肺癌的临床疗效相当,但前者不良反应小,患者生活质量优于后者。

Objective To explore the efficacy and safety of pemetrexed and cisplatin in the treatment of advanced nonsmall cell lung cancer. Methods 92 cases of advanced non-small cell lung cancer were divided into pemetrexed group and gemcitabine group. The 2 groups respectively received pemetrexed or gemcitabine combined with cisplatin. 1-,2-year survival rates,short term effect,median survival time and side effects were compared between the 2 groups. Results 1-,2-year survival rates were 64. 2% and 35. 7% in pemetrexed group,and those of gemcitabine group were 61. 9% and 31. 0%,there had no significant difference( P > 0. 05); Median survival time were 16. 8 and 17. 1 months in the 2 groups( P > 0. 05); Effective rates of gemcitabine group and pemetrexed group were 80. 9% and 83. 3%,and overall response rates were 45. 2% and 42. 9%( P > 0. 05);Ⅲ ~ Ⅳ grade of myelosuppression in pemetrexed group was much lower than that of gemcitabine group( 11. 9% vs 45. 2%,P <0. 05); KPS scores after treatment in pemetrexed group was superior to gemcitabine group( P < 0. 05). Conclusion Pemetrexed or gemcitabine combined with cisplatin have similar effect for advanced non-small cell lung cancer. Pemetrexed has less adverse reaction and better life quality.