吉西他滨联合多西他赛与培美曲塞联合顺铂治疗晚期恶性胸膜间皮瘤初步疗效对比

摘要

Objective:To investigate and compare the efficacy and safety of gemcitabine plus docetaxelregimen and pemetrexed plus cisplatinregimen chemotherapy for malignant pleural mesothelioma.Methods:In this retrospective study,data of the malignant pleural mesothelioma patients that treated with either GD regime or PP regime in hospital were analyzed.The efficacy of disease control rate and median survival and the side effects were compared between the two groups of treatment regime.Results:In a total data of 30 patients with malignant pleural mesothelioma were enrolled.The median courses of chemotherapy were 4 and 4.5,disease control rates were 85.7％ and 87.5％,and the median survival times were 14 months and 15 months in GD and PP groups,respectively,with no significant differences between the two groups (P =0.086,P =0.982,P =0.564).The incidence of hematology toxicity reaction in GD group was higher than that of PP group (64.3％ vs 18.8％,P =0.024).While the incidence of gastrointestinal reaction in GD group was lower than PP group (14.3％ vs 31.3％,P =0.399).Conclusion:The PP and the GD regimens showed similar efficacy in disease control rate and median survival time as first-line chemotherapy for advanced malignant pleural mesothelioma.Although the hematology toxicity of GD regimen is higher than that of PP regimen (mainly Ⅰ-Ⅱ degrees of bone marrowsuppression and acceptable).%目的:观察吉西他滨联合多西他赛与培美曲塞联合顺铂化疗治疗恶性胸膜间皮瘤(MPM)的疗效及安全性.方法:回顾性分析我院初诊的MPM患者,GD方案(吉西他滨联合多西他赛)为试验组,PP方案(培美曲塞联合顺铂)为对照组,21天为一个周期,对比两组间患者的临床疗效及毒副反应.结果:30例MPM中,GD组和PP组中位化疗周期(4 vs 4.5个)、疾病控制率(DCR) (85.7％ vs 87.5％)、中位生存时间(mOS)(14 vs 15个月),两组差异均无统计学意义(P =0.086、P=0.982、P=0.564).GD组血液学毒性发生率高于PP组(64.3％ vs 18.8％),两组血液学毒性有差异(P=0.024);但GD组胃肠道反应发生率低于PP组,两组间无统计学差异(14.3％ vs 31.3％,P=0.399).结论:GD方案与PP方案在晚期MPM患者一线化疗中疗效相当;GD方案在血液学毒性高于PP方案,但多以Ⅰ-Ⅱ度骨髓抑制为主,安全性可接受.