培美曲塞单药与培美曲塞联合顺铂二线治疗晚期胃癌的疗效对比

目的:观察培美曲塞联合顺铂作为二线方案治疗晚期胃癌与单纯使用培美曲塞的临床疗效。方法:选取晚期胃癌患者193例，随机分为两组。对照组96例，单纯使用培美曲塞治疗；观察组97例，使用培美曲塞联合顺铂进行治疗。于治疗3个疗程后对两组患者治疗效果进行评价，治疗6个月后对患者生存率进行随访。记录两组患者治疗期间不良反应发生情况。结果:经过3个疗程治疗，对照组患者PR、SD、PD以及RR分别为39.58%、28.13%、32.29%和39.58%；观察组分别为44.33%、27.84%、27.84%和44.33%，两组比较差异没有统计学意义。随访半年，对照组患者生存率为43.75%，观察组为72.16%，明显高于对照组，两组比较差异有统计学意义（P<0.05）。对照组患者血液学毒性、消化道反应、肝功能异常、肾功能异常、脱发以及神经毒性的发生率分别为63.54%、56.25%、12.50%、12.50%、67.71%和60.42%，观察组分别为68.04%、55.67%、15.46%、12.37%、68.04%和59.79%，两组相比无统计学意义。经过治疗，观察组患者日常生活、社会生活、抑郁、焦虑以及总分方面均较对照组明显高，两组比较差异有统计学意义（P<0.05）。结论:与培美曲塞单药治疗相比，培美曲塞联合顺铂二线治疗晚期胃癌可以有效延长患者的生存期，且不会增加患者的不良反应，是一种有效而安全的化疗方案。

Comparison of the effect of pemetrexed plus cisplatin as second - line treatment for ad-vanced gastric cancer

Objective:To observe pemetrexed plus cisplatin as second-line treatment on advanced gastric cancer.Methods:All 193 patients with advanced gastric cancer were randomly divided into two groups.The control group 96 cases，used pemetrexed therapy；97 cases in the observation group，to use pemetrexed plus cisplatin.Results:After three courses of treatment，in control group PR，SD，PD and RR were 39.58%，28.13%，32.29% and 39.58%,in observation group were 44.33%,27.84%,27.84% and 44.33%(P>0.05).Follow-up of six months，the survival rate of patients in the control group was 43.75% and in the observation group was 72.16%，the difference was statistically significant (P<0.05).Control patients rates of hematologic toxicity，gastrointestinal reactions，abnormal liver function，renal dysfunction，hair loss and the incidence of neurotoxicity were 63.54%，56.25%，12.50%，12.50%，67.71% and 60.42%，respectively，in the observation group were 68.04%，55.67%，15.46%，12.37%，68.04% and 59.79%(P>0.05).After treatment，the patients' daily life，social life，depression，anxiety and total score in the observation group was significantly higher than the control group，the difference was statistically significant (P<0.05).Conclusion:Compared with pemetrexed monotherapy to pemetrexed and cisplatin in second-line treatment of advanced gastric cancer can prolong survival of patients without increasing adverse reactions is an effective and safe chemotherapy.