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目的评价培美曲塞或吉西他滨联合卡铂治疗晚期非小细胞肺癌的临床疗效及安全性。方法将80例晚期非小细胞肺癌患者随机分为A组39例和B组41例。A组予以培美曲塞500 mg·m-2静脉滴注,第1天+卡铂5 mg·m L-1·min-1静脉滴注,第1天。B组予以吉西他滨1000 mg·m-2静脉滴注,第1,8天+卡铂5 mg·m L-1·min-1静脉滴注,第1天。2组患者1个周期均为21 d,共化疗4~6个周期。比较2组患者的客观有效率、疾病控制率、中位无进展生存期及不良反应发生情况。结果 A组客观有效率、疾病控制率及中位无进展生存期分别为33.33%、69.23%及5.8个月,B组分别为36.59%、63.41%及5.5个月,差异均无统计学意义(P>0.05)。A组发生Ⅲ~Ⅳ级消化道反应5例(12.8%),骨髓抑制4例(10.3%);B组发生Ⅲ~Ⅳ级消化道反应4例(9.8%),骨髓抑制13例(31.7%),B组Ⅲ~Ⅳ级骨髓抑制发生率显著高于A组(P<0.05)。结论培美曲塞联合卡铂与吉西他滨联合卡铂治疗晚期非小细胞肺癌患者的临床疗效相当,但前者不良反应发生率相对较低。
Objective To evaluate the clinical efficacy and safety of pemetrexed or gemcitabine plus carboplatin in the treatment of advanced non-small cell lung cancer. Methods Eighty patients with advanced non-small cell lung cancer were randomly divided into group A (39 cases) and group B (41 cases). Group A received pemetrexed 500 mg · m-2 intravenously, on the first day + carboplatin 5 mg · m L-1 · min-1 intravenously, on the first day. Group B received intravenous infusion of gemcitabine 1000 mg · m-2 and intravenous infusion of carboplatin 5 mg · m L-1 · min-1 on day 1 and day 8. Day 1. One cycle of the two groups of patients were 21 days, a total of 4 to 6 cycles of chemotherapy. The two groups of patients were compared objectively effective rate of disease control, progression-free survival and adverse reactions occurred. Results The objective effective rate, disease control rate and median progression-free survival in group A were 33.33%, 69.23% and 5.8 months respectively, while those in group B were 36.59%, 63.41% and 5.5 months, respectively, with no significant difference P> 0.05). In group A, 5 cases (12.8%) had digestive tract reactions of grade Ⅲ ~ Ⅳ and 4 cases (10.3%) had myelosuppression; group B had grade Ⅲ ~ Ⅳ gastrointestinal reactions in 4 cases (9.8%), bone marrow suppression in 13 cases ). The incidence of grade Ⅲ ~ Ⅳ myelosuppression in group B was significantly higher than that in group A (P <0.05). Conclusion Pemetrexed combined with carboplatin and gemcitabine combined with carboplatin in the treatment of advanced non-small cell lung cancer patients with similar clinical efficacy, but the former has a relatively low incidence of adverse reactions.