培美曲塞联合顺铂对晚期非小细胞肺癌的临床效果比较

目的观察多西紫杉醇、培美曲塞单药或联合顺铂治疗晚期非小细胞肺癌(NSCLC)的近期疗效和毒性反应。方法选择85例入我院治疗的经病理学或细胞学确诊为晚期非小细胞肺癌的患者,随机分为四组并分别按以下方案进行化疗。PM组:培美曲塞500mg.m-2,第1天静脉滴注,21天为一周期;PC组:培美曲塞500mg.m-2第1天静脉滴注,顺铂75mg.m-2,第1～3天,21天为一周期;DC组:多西紫杉醇75mg.m-2,第1天、第8天,静脉滴注1h;DP组:多西紫杉醇75mg.m-2,第1天、第8天,静脉滴注1h,顺铂75mg.m-2分3天于第1～3天静脉滴注,21天为一周期。结果比较各组治疗有效率、疾病控制率、一年生存率无显著统计学差异(P>0.05)。比较DC组与DP组、PM组与PC组、DP组与PC组之间的无进展生存期差异有显著性(P<0.05);DC组与PM组比较两组差异无显著性(P>0.05)。DC组与DP组、PM组与PC组之间白细胞数减少发生率差异有统计学意义(P<0.05);各组间其他毒副反应的发生率差异无统计学意义(P>0.05)。结论多西紫杉醇、培美曲塞单药或联合化疗治疗进展或晚期NSCLC均有疗效,联合用药较单药化疗方案治疗晚期NSCLC的临床疗效更好,且不良反应轻。

Clinical effects of Pemetrexed combined with Cisplatin on advanced non-small cell lung cancer

Objective To evaluate the efficacy and adverse reactions of docetaxel,pemetrexed,docetaxel plus cisplatin and pemetrexed plus cisplatin in the treatment of elderly advanced non-small cell lung cancer(NSCLC).Method 85 patients with advanced NSCLC treated in our hospital were divided into 4 groups and performed chemotherapy.Patients in PM group were treated with pemetrexed(pemetrexed 500 mg·m-2,intravenous infusion,D1).Patients in PC group were treated with pemetrexed plus cisplatin(pemetrexed 500 mg·m-2,intravenous infusion,D1,cisplatin 75 mg·m-2,intravenous infusion,D1-3,21 days for a cycle).Patients in DC group were treated with docetaxel(docetaxel 75 mg·m-2,intravenous infusion,D1,D8,21 days for a cycle).Patients in DP group were treated with docetaxel plus cisplatin(docetaxel 75 mg·m-2,intravenous infusion,D1,D8,cisplatin 75 mg·m-2,intravenous infusion,D1-3,21 days for a cycle).Results There was no significant difference of the effective rate,disease control rate and one year survival rate among four groups(P>0.05).The median progression-free survival between DC and DP groups,PM and PC groups as well as DP and PC groups were different(P<0.05),but no significant difference was observed between DC and PM groups(P>0.05).The incidence of leukopenia between DC and DP groups as well as PM and PC groups were significant different(P<0.05),there was no sinificant difference of the incidences of other adverse reactions between different groups(P>0.05).Conclusion Single application of docetaxel and pemetrexed or associated application of docetaxel and pemetrexed with cisplatin were all effective to treat NSCLC.Docetaxel plus cisplatin and pemetrexed plus cisplatin had better clinical effect than single application of docetaxel and pemetrexed in the treatment of NSCLC,and the incidence of adverse reactions were lower.