培美曲塞联合草酸铂与吉西他滨治疗晚期非小细胞肺癌

摘要

Objective:To evaluate the short - term efficacy and toxicities of pemetrexed combined with oxaliplatin or gemcitabine as second- line treatment for advanced non - small cell lung cancer. Methods: With the method of lottery, 30 patients with advanced non - small cell lung cancer were divided into two groups: the study group, pemetrexed combined with oxaliplatin (n = 15); and the control group, pemetrexed combined with gemcitabine (n= 1 5). Pemetrexed(500 mg/m2 , iv drip, d1) combined with oxaliplatm( 130 mg/m2 , iv drip, d1) were given every 3 - 4 weeks as a cycle for 2 - 4 cycles in the study group; pemetrexed (500 mg/m2, iv drip, d1) combined with gemcitabine (1250 mg/m2 , iv drip, d1 an d8) were given every 3 - 4 weeks as a cycle for 2 - 4 cycles in the control group. Results: (1) The short term effects: the effective rate was 33. 3% (5/15) in the study group and 26. 6%(4/15) in the control group (P>0. 05). The effective rate was 38% (8/21) in adenocarcinoma patients and 22. 2% (2/9) in squamous cell carcinoma patients (P<0. 05) ; (2) The study of Karnofsky performance status (KPS) : the effective rate of the study group was 73. 3% (11/15) and 53. 3% (8/15) in the control group (P<0. 05) ; (3)The study of side effects: the hematologic toxicity in the study group was significantly lower than that in the control group(P<0. 05). The other side effects in the two groups had no statistical difference(P>0. 05). Conclusions: The combination regiment of pemetrexed and oxaliplatin as second - line treatment for advanced non - small cell lung cancer has good efficacy.%目的:评价培美曲塞联合草酸铂与吉西他滨治疗晚期非小细胞肺癌的近期疗效及不良反应.方法:30例晚期非小细胞肺癌患者按抽签法分为研究组和对照组2组:(1)培美曲塞联合草酸铂化疗组(研究组)15例,培美曲塞500 mg/m2静脉滴注第1天给药,草酸铂130 mg/m2静脉滴注第1天给药,3～4周为1个周期,共2～4个周期;(2)培美曲塞联合吉西他滨化疗组(对照组)15例,培美曲塞500 mg/m2静脉滴注第1天给药,吉西他滨1250 mg/m2第1、第8天给药,3～4周为1个周期,共2～4个周期.结果:(1)近期疗效 研究组的有效率(33.3%,5/15)与对照组的有效率(26.6%,4/15)无显著差异(P>0.05).但腺癌患者的有效率(38%,8/21)与鳞癌患者的有效率(22.2%,2/9)的差异有统计学意义(P<0.05);(2)生存质量采用Karnofsky功能状态(Karnofsky performance status,KPS)评分标准,治疗后KPS评分较治疗前升高≥10分者为改善,升高<10分为稳定,下降者为进展,改善和稳定为有效.研究组有效率为73.3%(11/15);对照组有效率为53.3%(8/15),2组差异有统计学意义(P<0.05);(3)不良反应 研究组血液系统不良反应发生率低于对照组,2组差异有统计学意义(P<0.05).2组非血液系统不良反应发生率的差异无统计学意义(P>0.05).结论:培美曲塞联合草酸铂二线治疗晚期非小细胞肺癌有较好疗效,且不良反应发生率较低,患者更易耐受.