培美曲塞或紫杉醇联合顺铂治疗晚期肺腺癌的近期疗效比较

目的比较培美曲塞联合顺铂方案与紫杉醇联合顺铂方案治疗晚期肺腺癌的近期疗效及不良反应。方法对2009年1月-2012年12月收治入院的Ⅲ~Ⅳ期肺腺癌患者,根据患者意愿分为培美曲塞联合顺铂组（PP组）63例和紫杉醇联合顺铂组（TP组）61例,每组完成2个周期化学治疗（化疗）后进行疗效评价。结果 PP组和TP组有效率分别为58.7%、37.7%,疾病控制率分别为74.6%、52.5%,中位无进展生存期分别为6.1、4.5个月,两组比较差异均有统计学意义（P〈0.05）。PP组的恶心呕吐、白细胞减少发生率低于TP组,差异有统计学意义（χ2=16.164,P〈0.001;χ2=9.469,P=0.002）;血小板减少、贫血、肝肾功能损害发生率两组差异有统计学意义（χ2=0.098,P=0.755;χ2=0.267,P=0.606;χ2=0.006,P=0.973）。结论对于肺腺癌,培美曲塞联合顺铂方案较紫杉醇联合顺铂有更好的近期疗效,且不良反应较轻。

Recent Efficiency Comparison between Pemetrexed plus Cisplatin and Paclitaxel plus Cisplatin for Advanced Lung Adenocarcinoma

Objective To compare the recent efficiency and toxicity reactions of pemetrexed plus cisplatin and paclitaxel plus cisplatin for advanced lung adenocarcinoma. Methods One hundred and twenty-four patients with advanced lung adenocarcinoma treated in our hospital between January 2009 and December 2012 were divided into pemetrexed plus cisplatin group（group PP, n=63） and paclitaxel plus cisplatin group（group TP, n=61）. The effect was evaluated after two courses of treatment, and the toxicity reactions were evaluated every course. Results The objective response rate, disease control rate and progression-free survival in group PP and TP were respectively 58.7% vs 37.7%, 74.6% vs 52.5%, and 6.1 months vs 4.5 months, with significant differences（P 〈 0.05）. The incidence of nausea and vomiting, and white blood cell decrease（neutropenia） in group PP were significantly lower than that in group TP（χ2=16.164, P 〈 0.001; χ2=9.469, P=0.002）. There were no significant differences in incidence of thrombocytopenia, anemia and hepatic function damage（χ2=0.098, P=0.755; χ2=0.267, P=0.606; χ2=0.006, P=0.973）. Conclusion Pemetrexed plus cisplatin shows obviously superior effects and fewer side effects on advanced lung adenocarcinoma compared with paclitaxel plus cisplatin regime.