顺铂/卡铂联合培美曲塞治疗52例晚期肺腺癌的临床研究

目的探讨顺铂/卡铂联合培美曲塞治疗晚期肺腺癌的临床疗效。方法选取江苏省盐城市肿瘤医院2009年5月～2011年12月收治的晚期肺腺癌患者52例,随机分为两组,采用卡铂[静脉滴注5 mg/(mL.min)]联合培美曲塞(静脉滴注500 mg/m2)治疗的患者26例为对照组,采用顺铂(静脉滴注25 mg/m2)联合培美曲塞(静脉滴注500 mg/m2)治疗的患者26例为观察组,疗程均为4～6周,随访1年,比较两组患者的临床疗效和毒副反应情况。结果观察组有效率和疾病控制率均高于对照组,观察组中位疾病进展时间和中位生存期均长于对照组,观察组1年生存率(46.2%)高于对照组(38.5%),观察组皮疹、腹泻等毒副反应发生率均低于对照组,但差异均无统计学意义(P>0.05)。观察组肝肾功能损害、恶心呕吐等毒副反应发生率均明显高于对照组,观察组白细胞下降、血小板减少等毒副反应发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论顺铂联合培美曲塞治疗晚期肺腺癌的临床疗效略好于卡铂联合培美曲塞的治疗方案,患者的临床症状改善明显且毒副反应较轻,更适合临床使用。

Clinical research on 52 cases of advanced lung adenocarcinoma in the treatment with Cisplatin or Carboplatin combined with Pemetrexed

Objective To investigate the clinical efficacy on advanced lung adenocarcinoma in the treatment with Cisplatin or Carboplatin combined with Pemetrexed.Methods 52 patients with advanced lung adenocarcinoma were selected in Yancheng cancer hospital of Jiangsu Province from May 2009 to December 2011,who were divided into two groups randomly.26 patients used Carboplatin [intravenous infusion,5 mg/（mL·min）] combined with Pemetrexed（intravenous infusion,500 mg/m2） in the treatment as the control group.26 patients used Cisplatin（intravenous infusion,25 mg/m2） combined with Pemetrexed（intravenous infusion,500 mg/m2） in the treatment as the observation group.The course of treatment was 6 cycles.Patients were followed up for 1 years.Clinical efficacy and toxicity were compared between the two groups.Results Efficiency rate and disease control rate in the observation group were higher than those in the control group.Median time to disease progression and the median survival time in the observation group were longer than those in the control group.1 year survival rate in the observation group（46.2%） was higher than that in the control group（38.5%）.Adverse reaction rates of rash,diarrhea in the observation group were lower than those in the control group.But there were no significant differences（P 0.05）.Adverse reaction rates of liver and kidney dysfunction,nausea and vomiting in the observation group were significantly higher than those in the control group.Adverse reaction rates of leukopenia,thrombocytopenia in the observation group were significantly lower than those in the control group.The difference was statistically significant（P 0.05）.Conclusion Clinical curative effect of advanced lung adenocarcinoma in the treatment with Cisplatin and Pemetrexed is slightly better than the treatment with Carboplatin and Pemetrexed.Clinical symptoms of patients improve significantly while the toxicity is lighter.That is more suitable for clinical use.