培美曲塞与吉西他滨联合顺铂治疗晚期非小细胞肺癌比较

目的：比较培美曲塞联合顺铂方案与吉西他滨联合顺铂方案一线治疗晚期非小细胞肺癌的近期疗效、不良反应发生率和生存期,探讨方案的可行性。方法：30例经病理学或细胞学证实的ⅢB期或Ⅳ期非小细胞肺癌患者随机分成PEM组和GEM组,PEM组16例,GEM组14例。PEM组：培美曲塞500mg/m^2＋顺铂75mg/m^2,第1天,静滴并水化。GEM组：吉西他滨1000mg/m^2＋顺铂75mg/m^2,第1天,静滴并水化。两组方案均为每3周重复,每2周期进行疗效和不良反应评价,直至肿瘤进展或患者不能耐受为止。结果：PEM组和GEM组的客观缓解率（CR＋PR）分别为25.0%和21.4%,疾病控制率（CR＋PR＋SD）分别为81.3%和71.4%。中位疾病进展时间（MTTP）分别为6.3个月和5.8个月,中位生存期（MST）分别为11.9个月和10.1个月。两组间差异均无统计学意义（P〉0.05）。PEM组毒性发生率明显低于GEM组。结论：培美曲塞联合顺铂方案一线治疗晚期非小细胞肺癌,显示出良好的耐受性和有效性。

Pemetrexed plus cisplatin versus gemcitabine plus cisplatin for advanced non-small-cell lung cancer

Objective： To compare the short-term curative effect, side effects and survival of pemetrexed （ PEM ） plus cisplatin and gemcitabine （ GEM ） plus cisplatin for advanced non-small-cell lung cancer （ NSCLC ）. Methods： Thirty patients with stage Ⅲ B or Ⅳ NSCLC confirmed by pathology or cytology were randomly assigned to PEM group or GEM group. Patients in PEM group received intravenous infusion of pemetrexed （ 500mg/m^2 ） and cisplatin （ 75mg/m^2 ） with hydration on day 1 after admission. Patients in GEM group were given gemcitabine （ 1000mg/m^2 ） and cisplatin （ 75mg/m^2 ） with hydration on day 1 after admission. Treatment was repeated every 21 days. Response and toxicity were evaluated in patients who received two cycles of chemotherapy. Results： The response rate was 25.0% in PEM group and 21.4% in GEM group. The disease control rate was 81.3% in PEM group and 71.4% in GEM group. The time to progression was 6.3 months in PEM group and 5.8 months in GEM group. The survival time was 11.9 months in PEM group and 10.1 months in GEM group. There was no significant difference between the two groups （ P〉0.05 ）. The incidence rate of myelosuppression and non-hematology toxicity was lower in PEM group than in GEM group. Conclusion： Patients have a similar response rate to pemetrexed plus cisplatin and gemcitabine plus cisplatin and a lower toxicity than gemcitabine plus cisplatin. Pemetrexed plus cisplatin can be used in treatment of NSCLC.