培美曲塞联合奥沙利铂或顺铂一线治疗晚期肺腺癌的临床研究

目的比较培美曲塞联合顺铂和培美曲塞联合奥沙利铂一线治疗晚期肺腺癌的疗效和不良反应。方法选择经病理确诊的57例肺腺癌初治患者,随机分入PO组(培美曲塞500 mg/m2,第1天,奥沙利铂135 mg/m2,第1天,予以静脉滴注,每3周为1个疗程;n=29)和PC组(培美曲塞500 mg/m2,第1天,顺铂25 mg/m2,第1、2、3天,予以静脉滴注,每3周为1个疗程;n=28)。经两周期治疗后,评价两组疗效和不良反应。结果培美曲塞联合奥沙利铂组总反应率为37.9%,培美曲塞联合顺铂组为35.7%;培美曲塞联合奥沙利铂组临床获益率为72.4%,培美曲塞联合顺铂组为78.6%;培美曲塞联合奥沙利铂组无进展生存期为19周,培美曲塞联合顺铂组为22周;培美曲塞联合奥沙利铂组总生存期为41周,培美曲塞联合顺铂组为39周。两组比较,差异无统计学意义(P>0.05)。但培美曲塞联合奥沙利铂组患者3～4级呕吐发生率为3.4%,培美曲塞联合顺铂组为10.7%;培美曲塞联合奥沙利铂组患者3～4级中性粒细胞减少发生率为10.3%,培美曲塞联合顺铂组为21.4%,两组比较,差异有统计学意义(P<0.05)。结论使用培美曲塞联合奥沙利铂或者顺铂作为一线方案治疗晚期肺腺癌具有相同的疗效,但联合奥沙利铂具有更好的耐受性。

Clinical study on pemetrexed plus oxaliplatin or cisplatin as first-line chemotherapy for advanced lung adenocarcinoma

Objective To compare the efficacy and toxicity of pemetrexed plus oxaliplatin or cisplatin as the first-line chemotherapy for advanced lung adenocarcinoma.Methods 57 patients with advanced lung adenocarcinoma confirmed by pathologic examination without treatment were divided into two groups randomly.The PO group received pemetrexed（500 mg/m2 on 1d） and oxaliplatin（130 mg/m2 on 1 d） by intravenous infusion with 3 weeks as a treatment course（n=29）.The PC group received pemetrexed（500 mg/m2 on 1 d） and cisplatin（25 mg/m2 on 1,2,3 d） by intravenous infusion with 3 weeks as a treatment course（n=28）.The efficacy and toxicity were evaluated after two cycles of treatment.Results There were no significant difference in the overall response rate（37.9% vs 35.7%）,clinical benefit rate（72.4% vs 78.6%）,progress-free survival（19 weeks vs 22 weeks） and overall survival（41 weeks vs 39 weeks）between the PO group and PC group（P〉0.05）.However,compared with the PC group,less patients in the the PO group experienced the grade 3 or 4 vomitting（3.4% vs 10.7%） and the grade 3 or 4 neutropenia（10.3% vs 21.4%）,showing statistical difference between the two groups（P〈0.05）.Conclusion Pemetrexed combined with oxaliplatin or cisplatin as the first-line chemotherapy regimens for advanced lung adenocarcinoma has similar efficacy,but pemetrexed combined with oxaliplati has better tolerability than pemetrexed combined with cisplatin.