培美曲塞联合顺铂与长春瑞滨联合顺铂一线治疗晚期NSCLC的对比研究

目的 比较培美曲塞或长春瑞滨联合顺铂一线治疗晚期非小细胞肺癌（NSCLC）的疗效及毒副反应。方法 回顾性分析我院2008年1月至2010年12月收治的68例晚期NSCLC患者，分别接受培美曲塞联合顺铂（PC方案组，32例）或长春瑞滨联合顺铂（NP方案组，36例）一线治疗。PC方案组：培美曲塞500mg／m2，d1；顺铂 25mg／m²，d₁～d₃。NP方案组：长春瑞滨 25mg／m²，d₁、d₈，顺铂25mg／m²，d₁～d₃。每3周为1周期，每2个周期评价疗效。结果 所有患者均可评价近期疗效。两组均无完全缓解病例，PC方案组与NP方案组的有效率（RR）分别为40.6%（13/32）和36.1%（13/36），疾病控制率（DCR）分别为71.9%（23/32）和61.1%（22/36），两组RR和DCR的差异均无统计学意义（P＞0.05）。两组中位疾病进展时间（TTP）分别为6.2和5.2个月，组间差异无统计意义（P＞0.05）。NP方案组3～4级白细胞减少、中性粒细胞减少的发生率高于PC方案组（P＜0.05）。 结论 培美曲塞联合顺铂与长春瑞滨联合顺铂一线治疗晚期NSCLC的疗效相当，但培美曲塞的毒副反应较少。

Comparison of pemetrexed plus cisplatin regimen and vinorelbine plus cisplatin regimen as the first-line treatment of advanced non-small cell lung cancer

Objective To compare the efficacy and toxicity of pemetrexed plus cisplatin regimen and vinorelbine plus cispla- tin regimen as the first-line treatment of advanced non-small cell lung cancer （NSCLC）. Methods In a retrospective study, 68 pa- tients with advanced NSCLC receiving pemetrexed or vinorelbine plus cisplatin as the first-line chemotherapy from January 2008 to De- cember 2010 were enrolled. Subgroup and chemotherapy regimen were： PC regimen group（ n = 32, pemetrexed 500mg/m2, dj ; cispla- tin 25mg/m2, di -d3 ） and NP regimen group（ n = 36, vinorelbine 25mg/m2, d1 , ds ; cisplatin 25mg/m2, dI -d3 ）. Three weeks was a cycle. The efficacy was evaluated every 2 cycles. Results All patients were available for the objective response evaluation, but no complete response was observed in both groups. No significant difference was found between PC regimen group and NP regimen group on the objective response rate （40. 6% vs. 36. 1% ） , disease control rate （71.9% vs. 61.1% ） and median time to progress （6. 2 vs. 5.2 months）. There was a higher incidence of grade 3-4 leukopenia and neutropenia in the NP regimen group compared with the PC regimen group （ P 〈 0. 05 ）. Conclusion Pemetrexed plus cisplatin shows similar efficacy and less toxicity compared with vinorelbine plus cisplatin as the first-line treatment of advanced NSCLC.