培美曲塞联合顺铂与多西他赛联合顺铂治疗晚期非小细胞肺癌的疗效比较

目的比较培美曲塞联合顺铂与多西他赛联合顺铂治疗晚期非小细胞肺癌(NSCLC)的疗效及毒副反应。方法选择我科收治的Ⅲb/Ⅳ期非小细胞肺癌患者60例,采用同期对照研究,随机分为观察组和对照组,每组30例。观察组:培养曲塞500 mg.m-2静滴,d1,顺铂25 mg.m-2静滴,d1～3;对照组:多西地赛75 mg.m-2静滴,d1,8,顺铂25 mg.m-2静滴,d1～3。每3周为1周期重复。每2周期评价疗效,直至疾病进展。结果 60例患者均可评价疗效,观察组总有效率为15.6%,疾病控制率为42.3%,中位生存期为8.9个月,1 a生存率为26.7%;对照组总有效率为13.3%,疾病控制率为40.0%,中位生存期为8.2个月,1 a生存率为23.3%,2组比较差异均无统计学意义(P均>0.05)。观察组骨髓抑制、胃肠道反应、肝功能损害等毒副反应显著低于对照组(P均<0.05)。结论培美曲塞联合顺铂治疗晚期NSCLC的疗效与多西他赛联合顺铂的疗效相近,但毒副反应明显减少,可作为晚期NSCLC患者的一线治疗用药。

The Comparison of Efficacy of Pemetrexed or Docetaxel plus Cisplatin in the Treatment of Advanced Non-small Cell Lung Cancer

Objective To compare the efficacy and toxicities of pemetrexed or docetaxel plus cisplatin in the treatment of patients with non-small cell lung cancer(NSCLC).Methods The 60 patients with NSCLC were divided into the study group and the control group.The 30 patients in the study group received pemetrexed plus cisplatin chemotherapy: pemetrexed 500 mg·m-2,ivgtt,d1;cisplatin 25 mg·m-2,ivgtt,d1-3.The 30 patients in the control group received docetaxel plus cisplatin chemotherapy: docetaxel 75 mg·m-2,ivgtt,d1,8;cisplatin 25 mg·m-2,ivgtt,d1-3.The treatment would be repeated every 3 weeks.The efficacy and toxicities of two cycles were evaluated after two cycles of chemotherapy.Results In the study group,the response rate was 15.6,the disease control rate was 42.3,the median duration of survival was 8.9 months,the 1-year survival rate was 26.7;in the control group,the response rate was 13.3,the disease control rate was 40.0,the median duration of survival was 8.2 months,the 1-year survival rate was 23.3(P>0.05).The incidences of myelosuppression,gastrointestinal reaction,liver function injury in the study group were less than those of the control group(P<0.05).Conclusion Pemetrexed plus cisplatin has the same efficacy as docetaxel plus cisplatin in the treatment of patients with NSCLC,but the toxicities are less;pemetrexed plus cisplatin can be the first-line therapy for patients with NSCLC.