培美曲塞二钠联合奈达铂治疗晚期肺腺癌的临床研究

目的:观察培美曲塞二钠(PEM)及多西他赛(DTX)分别联合奈达铂(NDP)治疗晚期肺腺癌的临床疗效及不良反应.方法:共收集225例经病理和(或)细胞学确诊的中晚期肺腺癌患者,随机分为培美曲塞组(109例)和DTX组(116例).培美曲塞组采用PEM和NDP方案联合化疗,PEM 500 mg/m2,静脉滴入,d1；NDP 80 mg/m2,静脉滴入,d1,21 d为1个周期；DTX组采用DTX和NDP方案联合化疗,DTX 75 mg/m2,静脉滴入,d1；NDP 80 mg/m2,静脉滴入,d1,21d为1个周期.结果:培美曲赛组治疗有效率及控制率均比DTX组高,差异有统计学意义(x2=2.35,P=0.041；x2=4.23,P=0.033).培美曲赛组与DTX组不良反应两组间相比较差异均无统计学意义.其中不良反应发生率较高的是血红蛋白下降、白细胞下降和血小板下降,而肝肾功能损害较为少见,恶心、呕吐和食欲不振的发生率较低.结论:PEM联合NDP方案治疗晚期肺腺癌患者疗效好,不良反应较轻,患者耐受性好,值得在临床进一步推广验证.

Clinical observation of efficacy of pemetrexed plus nedaplatin in treatment of patients with advanced lung adenocacinoma

OBJECTIVE: To compare the efficacy and safety of pemetrexed or docetaxel plus nedaplatin in treatment of patients with advanced lung adenocacinma.METHODS: Totally 225 patients with advanced lung.adenocacinma were assigned to two groups: 109 patients received pemetrexed 500 mg/m2 plus nadapaltin 80 mg/m2(d1) and 116 patients received docetaxel 75 mg/m2 plus nadapaltin 80 mg/m2(d1).21 days as a cycle.RESULTS: Efficiency and control rate of pemetrexed group was higher than that of docetaxel group,and there was significant difference(χ2=2.35,P=0.041;χ2=4.23,P=0.033).Adverse reactions of pemetrexed group and docetaxel group showed no significant difference.Higher incidence of adverse reactions was hemoglobin decreased,leukopenia and thrombocytopenia,and rare liver and kidney dysfunction,nausea,vomiting and a low incidence of loss of appetite.CONCLUSION: Pemetrexed plus nedaplatin have the same activity as docetaxel plus nedaplatin in treatment of patients with advanced lung adenocacinoma,and they appeares to be more tolerated.