培美曲塞和吉西他滨分别联合奈达铂治疗晚期肺腺癌的疗效及安全性比较

目的 对培美曲塞联合奈达铂、吉西他滨联合奈达铂方案治疗晚期肺腺癌的疗效及安全性进行比较.方法 将入选的85例晚期肺腺癌患者随机分为培美曲塞组(n=43)和吉西他滨组(n=42).在支持治疗的基础上,培美曲塞组给予培美曲塞联合奈达铂治疗,吉西他滨组给予吉西他滨联合奈达铂治疗,可接受放疗的患者化疗后进行三维适形放疗,观察比较2组患者临床疗效、不良反应、总生存期、无进展生存期等.结果 培美曲塞组有效率为31.7％,疾病控制率为68.3％;吉西他滨组有效率为26.8％,疾病控制率为65.9％,2组间差异无统计学意义(x2值分别为1.737、0.082,P值均＞0.05).培美曲塞组Ⅲ级以上白细胞减少、粒细胞减少、血小板下降、恶心呕吐发生率明显低于吉西他滨组(P值均＜0.05).2组患者2年生存率、中位总生存期、中位无进展生存期比较差异均无统计学意义(P值均＞0.05).结论 培美曲塞联合奈达铂与吉西他滨联合奈达铂的疗效相似,但培美曲塞联合奈达铂不良反应较轻,更适用于晚期肺腺癌的治疗.

Comparison of clinical efficacy and safety of pemetrexed and gemcitabine combined with nedaplatin in treatment of advanced lung adenocarcinoma

Objective To compare the efficacy and safety of pemetrexed or gemcitabine combined with nedaplatin in the treatment of advanced lung adenocarcinoma.Methods 85 selected patients with advanced lung adenocarcinoma were divided into pemetrexed group (n ＝ 43) and gemcitabine group(n ＝42).On the basis of supportive treatment,patients in pemetrexed group were treated with pemetrexed combined with nedaplatin and patients in gemcitabine group were treated with gemcitabine combined with nedaplatin.Patients who could received radiotherapy after chemotherapy were treated with three dimensional conformal radiation therapy.The clinical efficacy,adverse reactions,overall survival,and progression free survival of the two groups were observed and compared.Results The total effective rates of pemetrexed group and gemcitabine group were 31.7％ and 26.8％,the disease control rates were 68.3％ and 65.9％,there was no significant difference between the two groups (x2 =1.737,0.082,respectively,all P ＞0.05).The incidence rates of aleucocytosis,granulocytopenia,platelet decline,nausea and vomitting above Ⅲ grade in pemetrexed group were significantly lower than those in gemcitabine group (all P ＜0.05).There was no statistical difference in two-year survival rate,median overall survival,median progression-free survival between two groups (all P ＞0.05).Conclusions Pemetrexed combined with nedaplatin has similar efficacy and lighter adverse reactions compared with gemcitabine combined with nedaplatin,so it is more suitable for the treatment of advanced lung adenocarcinoma.