培美曲塞联合奈达铂一线方案治疗晚期肺腺癌的临床研究

目的 观察和评价培美曲塞联合奈达铂与多西他赛联合奈达铂作为一线化疗方案治疗晚期肺腺癌的临床疗效和不良反应。方法 68例初治的晚期肺腺癌患者，体力状况（PS）评分0～2分，34例培美曲塞 500 mg/m2联合奈达铂80 mg /m2；34例多西他赛75 mg/m2联合奈达铂80 mg /m2治疗。结果 入组的68例患者中有67例可评价疗效。培美曲塞组与多西他赛组比较疾病控制率分别为 45.45%和44.12%，中位生存时间分别为8.5月和8.2月，1年生存率为30.3%和26.5%。两组比较差异均无统计学意义（P >0.05）。在中性粒细胞减少和脱发的发生率上培美曲塞观察组均明显低于多西他赛对照组，差异有统计学意义（P＜0.05）。其余恶心、呕吐、乏力等不良反应，两组比较差异无统计学意义。结论 培美曲塞与多西他赛分别联合奈达铂治疗晚期肺腺癌的疗效相当，但在不良反应的发生率上，培美曲塞组则显示出更好的优势。

Clinical Curative Effects of Pemetrexed Plus Nedaplatin as First-line Treatment in#br# Patients with Advanced Lung Adenocarcinoma

Objective To observe and appraise the effi cacy and safety of pemetrexed and docetaxel combinedwith Nedaplatin respectively as the first-line therapy for patients with advanced lung adenocarcinoma .Methods Sixty-eight newly diagnosed patients with advanced lung adenocarcinoma, with physical status(PS) 0-2 were involved. Thirty four patients received nedaplatin 80 mg/m2 combined with pemetrexed 500mg/m2. The rest of 34 patients received nedaplatin 80 mg/m2 combined with docetaxel 75 mg/m2. ResultsSixty-seven patients were evaluable for effi cacy from the 68 cases. Disease control rate were 44.12 % vs.44.12%, median survival time were 8.5 months vs. 8.2 months, and the 1-year survival rate were 30.3% vs.26.5%, in the pemetrexed group vs. the Docetaxel group respectively. No statistically signifi cant differenceswere found between the two groups(P >0.05). The incidence of treatment emergent neutropenia and alopeciaoccurred in the observation group were signifi cantly lower than that in the control group（P＜0.05）. Nosignifi cant differences were found in adverse reactions, such as nausea, vomit and fatigue, of both groups（P >0.05）. Conclusion The similar efficacy were observed in Pemetrexed plus Nedaplatin group andDocetaxel plus Nedaplatin group for advanced lung adenocarcinoma. However, Pemetrexed group showedmore advantages on the incidence of adverse reactions.