目的观察培美曲塞与多西他赛分别联合顺铂治疗晚期非小细胞肺癌的临床疗效和药物安全性。方法将95例晚期非小细胞肺癌患者随机分为两组，培美曲塞组48例，给予第1 d 静脉滴注培美曲塞500 mg·m-2，第1～3 d 静脉滴注顺铂25 mg·m-2；多西他塞组47例，给予第1、8 d 静脉滴注多西他赛75 mg·m-2，第1～3 d 静脉滴注顺铂25 mg·m-2。每3周为1周期，每2疗程评价临床疗效，观察不良反应的发生情况。结果培美曲塞组与多西他赛组的总缓解率分别为22.92％和17.02％，疾病控制率分别为52.08％和46.81％，差异均无统计学意义（P>0.05）；但培美曲塞组不良反应如白细胞减少、贫血、血小板减少、恶心呕吐、肝功能异常的发生率明显低于多西他赛组（P<0.01）。结论培美曲塞与多西他赛联合顺铂治疗非小细胞肺癌的疗效相当，但培美曲塞联合顺铂的毒副作用相对较低，患者耐受性更好。%Objective To investigate the clinical efficacy and safety of pemetrexed and docetaxel respectively combined with cisplatin in the treatment of advanced non-small cell lung cancer. Methods 95 patients with advanced non-small cell lung cancer were selected and randomly divided into two groups. 48 patients in the pemetrexed group were given intravenous infusion of pe-metrexed 500 mg·m-2 at d1, and intravenous infusion of cisplatin 25 mg·m-2 at d1 ~ d3; 47 patients in the docetaxel group were given intravenous infusion of docetaxel 75 mg·m-2 at d1 and d8, and intravenous infusion of cisplatin 25 mg·m-2 at d1~ d3. Three weeks’treatment was taken as a cycle, and the clinical efficacy and incidence of adverse reactions were observed and compared after every two cycles’treatment. Results The overall response rates of pemetrexed group and docetaxel group were respectively 22.92% and 17.02%, and the disease control rates were respectively 52.08% and 46.81%; there was no significant difference be-tween the two groups (P>0.05). However, the incidence rates of adverse reactions such as leukopenia, anemia, thrombocytope-nia, nausea and vomiting, liver dysfunction in pemetrexed group was significantly lower than that in the docetaxel group (P<0.01). Conclusion Pemetrexed combined with cisplatin had equal efficacy as but less adverse reactions than docetaxel combined with cisplatin in the treatment of non-small cell lung cancer.
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