吉西他滨或培美曲塞联合顺铂治疗晚期非小细胞肺癌的临床观察

目的比较吉西他滨或培美曲塞联合顺铂一线治疗晚期非小细胞肺癌的疗效及毒副反应。方法将43例晚期非小细胞肺癌患者随机分为培美曲塞加顺铂组(PC)20例和吉西他滨加顺铂组(GC)23例。PC组培美曲塞500㎎/㎡,静滴,第1天,联合顺铂25㎎/㎡,静滴,第1～3天。GC组吉西他滨1250mg/m2,静滴,第1、8天,联合顺铂25mg/m2,静滴,第1～3天。两组均21天为一周期,每例患者至少完成两个周期以上。结果培美曲塞加顺铂组和吉西他滨加顺铂组有效率分别为45%和47.8%,两组之间总有效率无统计学差异(P>0.05)。PC组白细胞减少和血小板减少的发生率小于GC组(P<0.05)。结论培美曲塞联合顺铂一线治疗晚期非小细胞肺癌与吉西他滨联合顺铂的疗效相当,但毒副作用较轻,可在临床优选使用。

A clinical study on the combination of gemcitabine or pemetrexed and cisplantin in the treatment of advanced non-small cell lung cancer

Objective To evaluate the efficacy and toxicity of the combinatio n of gemcitabine or pemetrexed and cisplatin in the treatment of patients with a dvanced non-small cell lung cancer(NSCLC).Methods43 patien ts with locally ad vanced(stage Ⅲ) or metastatic(stage Ⅳ) NSCLC were enrolled into the study.T hese patients were divided into PC group(20 patients :pemetrexed 500kg/m2 on day 1 and cisplatin 25kg/m2 on day 1-3 day of 21-day cycle) and GC group(2 3 pati ents :gemcitabine 1250kg/m2 on day 1、8 and cisplatin 25kg/m2 on day 1-3 da y of the 21-day cycle).Each patient should complete two cycle.ResultsThe response rate in PC was 45%and in GC was 47.8%(P>0.05).The main toxicities were hema tological toxicities,nausea and vomiting,but they were rarer in PC group.ConclusionIn the treatment of advanced NSCLC,the combination of pemetrexed and cisplatin had the same activity as the combination of gemcitabine and cisplatin, and they appeared to be more-tolerated.