培美曲塞联合顺铂治疗晚期非小细胞肺癌患者的临床疗效及安全性

Clinical Efficacy and Safety of Pemetrexed Combined with Cisplatin in the Treatment of Advanced Non-small Cell Lung Cancer

目的观察培美曲塞联合顺铂治疗晚期非小细胞肺癌患者的临床疗效及安全性。方法将78例晚期非小细胞肺癌患者按照随机数字表法分为对照组和观察组,各39例。对照组采用吉西他滨1 250 mg/m2静脉滴注,d1;顺铂,75 mg/m2,d1~3,21 d为1周期治疗;观察组于对照组治疗基础上采用培美曲塞,500 mg/m2静脉滴注,d1;顺铂,75mg/m2,d1~3,21 d为1周期。观察2组患者临床疗效和远期疗效(6个月、1、3年生存率)及不良反应、生存质量。结果观察组治疗有效率为56.41%(22/39),与对照组的53.85%(21/39)比较,差异无统计学意义(χ2=12.20,P>0.05);观察组6个月、1、3年生存率分别为48.72%(19/39)、30.77%(12/39)、20.51%(8/39),与对照组46.15%(18/39)、33.33%(13/39)、15.38%(6/39)比较,P>0.05;观察组发生白细胞降低等不良反应率为38.46%(15/39),明显低于对照组56.41%(22/39)(χ2=13.28,P<0.05)。2组患者生存质量评分均明显改善,但观察组优于对照组(P<0.05)。结论培美曲塞联合顺铂治疗晚期非小细胞肺癌与吉西他滨联合顺铂治疗效果相当,但培美曲塞联合顺铂治疗所产生的不良反应少,生存质量高,安全性较高,更值得推广应用。

Objective To observe the clinical efficacy and safety of pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC).Methods 78 patients with advanced NSCLC were randomly divided into the control group and the observation group,each with 39 cases.The control group received gemcitabine 1 250 mg/m2 intravenously,d1; cisplatin,75 mg/m2,d1 ~ 3,21 d was a cycle; the observation group on the basis of the control group received pemetrexed,500 mg/m2 intravenously,d1; cisplatin,75 mg/m2,d1 ~ 3.The clinical efficacy,long-term effects(6-month,1-,3-year survival rates),adverse reactions,and quality of life of the 2 groups were observed.Results Effective rate of the observation group was 56.41%(22 /39),and that of the control group was 53.85%(21 /39),the difference was not statistically significant(χ2= 12.20,P >0.05); 6-month,1-,3-year survival rates in the observation group were 48.72%(19 /39),30.77%(12 /39),and 20.51%(8 /39),and those of the control group were 46.15%(18 /39),33.33%(13 /39),and 15.38%(6 /39),P > 0.05; leukopenia in the observation group was 38.46%(15 /39),which was significantly lower than that of the control group,56.41%(22 /39)(χ2= 13.28,P < 0.05).Quality of life scores of the 2 groups significantly improved,but the observation group was better than the control group(P < 0.05).Conclusion Pemetrexed combined with cisplatin for advanced NSCLC has similar effect as gemcitabine combined with cisplatin,but pemetrexed combined with cisplatin has less adverse reactions,and higher quality of life,it has higher security,and it is worthy of popularization and application.