顺铂分别联合培美曲塞和吉西他滨治疗晚期非小细胞肺癌的临床疗效分析

目的探讨顺铂分别联合培美曲塞和吉西他滨治疗晚期非小细胞肺癌（NSCLC）的临床疗效和不良反应。方法将2009年3月至2011年2月收治并入选的86例晚期NSCLC患者随机分为A组（n=44例）和B组（n=42例），A组患者采用顺铂＋培美曲塞方案治疗，B组患者采用顺铂＋吉西他滨方案治疗，两组患者均化疗4个周期，化疗结束后进行2年的随访观察，记录并分析两组患者化疗结束后1个月的临床疗效、生活质量评分、化疗期间药物不良反应及化疗以后2年生存率。结果（1）化疗结束后，两组患者临床疗效构成和总体有效率未见明显差异，A组腺癌患者化疗后1个月KPS评分高于B组（P=0．030）。（2）两组患者化疗期间药物不良反应类型及发生率相近，A组患者粒细胞减少比例（31．8％）低于B组患者（54．8％），差异有统计学意义（P=0．032）。（3）两组患者化疗后2年生存率与病死者平均生存月数无明显差异，但A组腺癌患者2年生存率与病死者平均生存月数均高于B组腺癌患者（均P〈0．05）。结论顺铂联合培美曲塞治疗晚期NSCLC的疗效与顺铂联合吉西他滨相当，但腺癌患者的临床疗效优势明显，药物不良反应发生率相对较低。

Comparative study on clinical efficacy of cisplatin combined pemetrexed and gemcitabine respectively in palliative treatment of advanced non-small-cell lung cancer

Objective To compare clinical efficacy of cisplatin （DDP） combined with pemetrexed （PEM） and gemcitabine （GEM） in palliative treatment of advanced non-small cell lung cancer （NSCLC）, respectively. Methods 86 admitted cases from Mar. 2009 to Feb. 2011 were randomized into group A （n =44） and group B （n =42）. Group A was applied with DDP ＋ PEM scheme, and group B was applied with DDP ＋GEM scheme. Two years of follow-up after 4 cycles＇ chemotherapy was conducted, and the clinical efficacy, quality of life score after 1 month of chemotherapy, drug toxicity during chemotherapy and 24 months survival rate were noted and compare＆ Results （1） After chemotherapy, there was no statistical differences on clinical curative efficacy and overall efficiency between groups. The KPS score of patients with adenocarcinoma after one month chemotherapy was higher than that of group B （P =0.030）. （2） The drug toxicities during chemotherapy of the two groups were consistent,while the neutropenia pmpartion of group A （31.8%） was lower than that of group B （ 54. 8%, P = 0. 032 ）. （3） 2 years survival rate and average survival months had no significant difference, but the two years survival rate and average survival months of adenocareinoma patients in group A were both higher than counterparts of group B （P 〈 0. （15）. Conclusions DDP ＋ PEM scheme and DDP ＋ GEM scheme in treatment of advanced NSCLC had comparative clinical efflcacy,but higher survival rate was observed in adenocarcinoma patients of group A, and with less drag toxicity.