Objective To compare the efficacy and toxicity of pemetrexed combined with cisplatin and docetaxel combined with cispla-tin in the treatment of advanced lung adenocarcinoma. Methods The clinical data of 70 patients of advanced lung adenocarcinoma confirmed by pathology and medical imaging from February 2010 to February 2013 were studied. The efficacy and toxicity of the two schemes were as-sessed. Results The response rate (22. 86% vs 20%, P>0. 05), disease control rate(48. 57% vs 45. 71%, P>0. 05), median survival time (8. 8m vs 8. 3m, P>0. 05), 1-year survival rate (26. 2% vs 23. 8%, P>0. 05) in pemetrexed group was higher than those in docetaxel group, but there was no significant differences. In pemetrexed group, the bone marrow suppression, gastrointestinal reaction, liver-kidney function injury were less than in docetaxel group, and the difference was statistically different. Conclusion Pemetrexed and docetaxel are ef-fective as first-line treatment in patients with advanced lung adenocarcinoma, but the adverse reactions of the pemetrexed group are less than docetaxel group, which can be used as the first choice.%目的：比较培美曲塞联合顺铂和多西他赛联合顺铂一线治疗晚期肺腺癌的临床疗效及安全性评价。方法对2010年2月至2013年2月经病理及影像学证实晚期且初治的肺腺癌患者共计70例,采用随机对照研究,随机分为培美曲塞组和多西他赛组各35例,分析其临床疗效及不良反应发生情况,评估两药对晚期肺腺癌患者的作用。结果临床疗效上,培美曲塞组较多西他赛组在化疗有效率(22.86% vs 20%,P>0.05)、疾病控制率(48.57% vs 45.71%,P>0.05)、中位生存时间(8.8个月 vs 8.3个月,P>0.05)、一年生存率(26.2% vs 23.8%,P>0.05)上虽然有一定优势,但统计学上均未表现出统计学差异。在两组的不良反应中,培美曲塞组骨髓抑制(42.86% vs 77.14%, P<0.05)、胃肠道反应(28.57% vs 60.0%,P<0.05)及肝肾功能损害(8.57% vs 54.29%,P<0.05)等毒副作用发生率均低于多西他赛组。结论培美曲塞及多西他赛均是治疗晚期肺腺癌患者的有效一线方案,但培美曲塞的血液学毒性及胃肠道反应明显轻于多西他赛组,可作为优先选择。
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