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目的:比较培美曲塞联合顺铂(PEM)方案与吉西他滨联合顺铂(GEM)方案一线治疗晚期非小细胞肺癌(NSCLC)的疗效及耐受性。方法:30例经组织学确诊的ⅢB期或Ⅳ期初治NSCLC患者随机分成PEM组和GEM组,每组各15例。结果:PEM组RR为40.0%,PFS为5.60个月,OS为18.07个月;GEM组RR为20.0%,PFS为6.50个月,OS为18.10个月,两组比较差异均无统计学意义,P值分别为0.182、0.431和0.516。肺腺癌中PEM组RR、PFS及OS均好于GEM组,但差异无统计学意义,P>0.05。两组主要毒副反应均为骨髓抑制和胃肠道反应,PEM组患者Ⅲ/Ⅳ度血液学毒性发生率均低于GEM组患者,差异无统计学意义,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,特别是肺腺癌,疗效确切,耐受性良好。
Objective: To compare the efficacy and tolerability of first-line treatment of advanced non-small cell lung cancer (NSCLC) with pemetrexed plus cisplatin (PEM) and gemcitabine plus cisplatin (GEM). Methods: Thirty patients with stage ⅢB or Ⅳ NSCLC diagnosed by histology were randomly divided into PEM group and GEM group, with 15 cases in each group. Results: The RR of PEM group was 40.0%, PFS was 5.60 months and OS was 18.07 months. In GEM group, RR was 20.0%, PFS was 6.50 months and OS was 18.10 months. There was no significant difference between two groups P values were 0.182, 0.431 and 0.516 respectively. Pneumothorax in PEM group RR, PFS and OS were better than GEM group, but the difference was not statistically significant, P> 0.05. The main adverse reactions of both groups were myelosuppression and gastrointestinal reaction. The incidence of grade Ⅲ / Ⅳ hematologic toxicity in PEM group was lower than that in GEM group, the difference was not statistically significant (P> 0.05). Conclusion: Pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer, especially lung adenocarcinoma, is effective and well tolerated.