Objective To prospectively evaluate the efficacy and toxicity of docetaxel plus cisplatin (DP regi-men) compared with pemetrexed plus cisplatin (PP regimen) as a first-line treatment for advanced lung adenocarcinoma. Methods Sixty-six patients with advanced lung adenocarcinoma at the beginning of treatment were collected from Au-gust 2012 and August 2014 in the First Affiliated Hospital of Xi'an Jiaotong University (46 cases) and the Affiliated Hui-dong Hospital of Guangdong Medical College (20 cases). The patients were randomly assigned to two regimens:DP regimen (DP group, n=33) and PP regimen (PP group, n=33). The response rate (RR), disease control rate (DCR), time to disease pro-gression (TTP), median survival time (MST), 1-year survival rate, and side effects were observed. Results Among the 33 cases of DP group, there were 10 cases of partial response (PR), 15 cases of stable disease (SD) and 8 cases of progres-sive disease (PD), with the RR and DCR of 30.30%(10/33) and 75.76%(25/33), respectively. The TTP, MST, the 1-year survival rate were 7.8 months, 13.5 months, 54.5%(18/33), respectively. Among the 33 cases in the PP group, there were 11 cases of PR, 16 cases of SD and 6 cases of PD, with the RR and DCR of 33.33%(11/33) and 81.82%(27/33), respec-tively. The TTP, MST, and the 1-year survival rate were 8.1 months. 14.8 months, 57.58%(19/33), respectively. Recent efficacy and survival rates showed no statistically significant difference between the two groups. The main side effects of the two groups included hematologic toxicities, digestive tract reaction and hair loss. The incidence of neutropenia, throm-bocytopenia, and hair loss in the PP group was significantly lower than that in the DP group (P<0.05). Conclusion The two regimens have similar efficacy as a first-line treatment for advanced lung adenocarcinoma. The major toxicities of the two regimens are well tolerable.%目的 观察多西他赛联合顺铂方案(DP方案)与培美曲塞联合顺铂方案(PP方案)一线治疗晚期肺腺癌的近期疗效和不良反应.方法 收集2012年8月至2014年8月在西安交通大学第一附属医院(46例)和广东医学院附属惠东医院(20例)收治的66例初治晚期肺腺癌患者,采用随机对照的临床研究设计,将66例经组织学或细胞学确诊的初治晚期肺腺癌患者分为DP方案组和PP方案组各33例.观察两组患者的近期有效率(RR)、疾病控制率(DCR)、疾病进展时间(TTP)、中位生存时间(MST)、1年生存率和不良反应.结果 DP方案组中,部分缓解(PR)10例,疾病稳定(SD)15例,疾病进展(PD)8例,RR为30.30%(10/33),DCR为75.76%(25/33);TTP为7.8个月,MST为13.5个月,1年生存率为54.55%(18/33).PP方案组中,PR 11例,SD 16例,PD 6例,RR为33.33%(11/33),DCR为81.82%(27/33),TTP为8.1个月,MST为14.8个月,1年生存率为57.58%(19/33).两组患者的近期疗效和生存率比较差异均无统计学意义(P≥0.05).两组患者的主要不良反应为血液学毒性、消化道反应和脱发.PP组的不良反应中中性粒细胞减少、血小板减少及脱发的发生率明显低于DP组,差异具有统计学意义(P<0.05).结论 DP方案和PP方案治疗晚期肺腺癌疗效确切,不良反应均可耐受.
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