目的 研究培美曲塞和多西他赛单药二线治疗晚期非小细胞肺癌的临床疗效和毒副作用.方法 78例晚期非小细胞肺癌(ⅢB~Ⅳ期)患者随机分为两组,病理类型均为腺癌,培美曲塞组(A组)39例采用培美曲塞单药化疗,多西他赛组(B组)39例采用多西他赛单药化疗,3周为1个疗程.比较两组患者的无进展生存期(PFS)、中位生存时间、临床疗效及毒副反应.结果 近期有效率:A组与B组有效率分别为76.92%和69.23%,两组差异无统计学意义(P＞0.05).生存时间:A组与B组中位无进展生存期分别为 3.1个月,2.9个月,中位生存时间分别为9.1个月和 7.9个月,两组差异有统计学意义(P<0.01).毒性反应:A组药物相关性血液学毒性明显低于B组(P<0.01).两组患者不良反应患者均可耐受.结论 培美曲塞和多西他赛单药二线治疗晚期非小细胞肺癌均是安全有效的治疗方法,但培美曲塞较多西他赛的毒性反应更轻.%Objective To compare the clinical efficiency and toxicities between pemetrexed and docetaxel in the second line treat ment of non small cell lung cancer(NSCLC). Methods 78 advanced stage( Ⅲ B-Ⅳ period) patients,with pathological type of ade nocarcinoma,were randomly divided into two groups,39 cases of pemetrexed group group A) received pemetrexed, and docetaxel group (group B) received docetaxel, 3 weeks as a course. Then we observed and compared the PFS and the median survival time of the two groups.and evaluated the toxicities at the same time. Results Recent efficiency: effective rates in the group A, B were 76.92% and 69.23%;The result showed no significant difference(P＞0. 05). Survival time:the non advancement time of group A was 3. 1 months, which was better than that in the group B(2. 9 months) ;the median survival times of group A,B were 9. 1 and 7. 9 months(P＜0.01). Toxicities:drug related hematology toxicity in the group A was lower than that in the group B(P＜0.01), In two groups,the toxicities were tolerable. Conclusion Pemetrexed and docetaxel are both safe and efficacious treatments of advanced NSCLC patients,but the toxicities of pemetrexed is lower than that of docetaxel.
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