吉西他滨与培美曲塞联合顺铂治疗非小细胞肺癌的疗效比较及对血清肿瘤标志物的影响

目的 探讨吉西他滨与培美曲塞联合顺铂治疗非小细胞肺癌(NSCLC)的疗效及其对血清肿瘤标志物的影响.方法 选取晚期NSCLC患者95例,随机分为对照组48例和观察组47例.在常规治疗基础上,对照组采用吉西他滨联合顺铂的治疗方案,观察组则采用培美曲塞联合顺铂的治疗方案.观察比较两组患者的治疗总有效率,治疗前后的血清肿瘤标志物水平,包括血清癌抗原125(CA125)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)以及细胞角质素片段抗原(Cyfra21-1),以及不良反应的发生情况.结果 治疗后,观察组临床治疗有效率为46.8％,对照组临床治疗有效率为43.8％,两组比较差异无统计学意义(P＞0.05).两组患者血清肿瘤标志物CA125、CEA、NSE及Cyfra21-1水平均有明显下降,且观察组的该4个指标水平显著低于对照组,差异具有统计学意义(P＜0.05).此外,观察组中性粒细胞减少、贫血以及血小板减少发生率显著低于对照组(P＜0.05),而其他不良反应的发生情况比较无明显差异(P＞0.05).结论 培美曲塞联合顺铂与吉西他滨联合顺铂的治疗方案在NSCLC治疗中均效果良好,但培美曲塞联合顺铂治疗可明显改善血清肿瘤标志物水平,且不良反应发生率低,安全性好.

Comparison of Clinical Efficacy of Pemetrexed or Gemcitabine Combined with Cisplatin for Patients with Non-small Cell Lung Cancer and Its Influence on Serum Tumor Markers

Objective To investigate the clinical efficacy of pemetrexed or gemcitabine combined with cisplatin for pa tients with non-small cell lung cancer (NSCLC) and its influence on serum tumor mnarkers.Methods 95 patients with NSCLC were randomly divided into the control group and the observation group.Based on conventional treatments,48 patients in the control group were treated with gemcitabine combined with cisplatin,and 47 patients in the observation group were treated with pemetrexed combined with cisplatin.The clinical efficacy,serum tumor markers including carcinoembryonic antigen (CEA),carbohydrate antigen 125 (CA125),neuronspecific anolase (NSE),and cytokeratin fragment antigen 21-1 (Cyfra21-1),and adverse reaction were investigated and compared.Results After treatment,total effective rate of the observation group was 46.8％,and that of the control group was 43.8％ (P ＞ 0.05).And serum tumor markers including CA125,CEA,NSE,and Cyfra21-1 in bothgroups markedly decreased (P ＜ 0.05),and the 4 markers in the observation group were much lower than those of the control group (P ＜ 0.05).In addition,the incidence rate of neutropenia,anemia,and thrornbocytopenia in the observation were significantly lower than those of the control group (P ＜ 0.05),while the changes in other adverse reactions between the 2 groups had no significant difference(P ＞0.05).Conclusion Gemcitabine combined with carboplatin and pemetrexed combined with cisplatin are effective for NSCLC,but pemetrexed combined with cisplatin can improve the levels of serum tumor markers with lower incidence of adverse reactions.