培美曲塞或吉西他滨联合顺铂治疗晚期肺腺癌的对照研究  

Comparative Study of Pemetrexed or Gemcitabine Combined with Cisplatin for Advanced Lung Adenocarcinoma

作　　者：邓颖[1] 胡洪林[1] 杨兰 潘海霞[1] 朱学强[1] 

机构地区：[1]四川省人民医院肿瘤科,610071

出　　处：《实用癌症杂志》2014年第3期330-332,共3页The Practical Journal of Cancer

摘　　要：目的：探讨培美曲塞与吉西他滨联合顺铂一线治疗晚期肺腺癌的近期疗效及不良反应。方法2009年2月至2012年12月收治的Ⅲb期及Ⅳ期肺腺癌60例，随机分为2组。实验组（ PP组）30例，采用培美曲塞500 mg/m2静脉滴注，第1天；顺铂25 mg/m2静脉滴注，第1～3天，每3周为1个化疗周期。对照组（ GP组）30例，采用吉西他滨1000 mg/m2静脉滴注，第1天；顺铂25 mg/m2静脉滴注，第1～3天，每3周为1个化疗周期。2个周期后进行疗效评价及不良反应评价。结果实验组和对照组有效率分别是30．0％和26．7％，疾病控制率分别为66．7％和70．0％，差异无统计学意义（P＞0．05）；不良反应显示实验组和对照组Ⅲ-Ⅳ度白细胞减少的发生率分别为13．3％（4/30）和40．0％（12/30），差异有统计学意义（P＜0．05）；Ⅲ-Ⅳ度贫血发生率分别为3．3％（1/30），6．7％（2/30），差异无统计学意义（P＞0．05）；Ⅲ-Ⅳ度血小板下降的发生率分别为6．7％（2/30），36．7％（11/30），差异有统计学意义（P＜0．05）。肝肾功能损害差异无统计学意义；恶心呕吐发生率，2组差异无统计学意义；脱发的发生率实验组和对照组分别为10．0％（3/30），33．3％（10/30），差异有统计学意义（P＜0．05）。结论培美曲塞联合顺铂治疗晚期肺腺癌疗效确切，且耐受性好。Objective To explore the efficacy and toxicities of pemetrexed or gemcitabine combined with cisplatin in the first-line treatment of advanced lung adenocarcinoma .Methods 60 cases of stage Ⅲb and stage Ⅳ lung adenocarcinoma were randomly divided into two groups.The experimental group (PP group) 30 cases,with pemetrexed 500 mg/m2 intravenous infusion of D1+cisplatin 25 mg/m2 intravenous infusion of D1-3,every 3 weeks for 1 cycle of chemotherapy .The control group ( GP group) 30 cases,with gemcitabine intravenous infusion of 1 000mg/m2 D1+and cisplatin 25 mg/m2 intravenous infusion of D1-3,every 3 weeks for 1 cycle of chemotherapy .Curative effects and adverse reactions were evaluated after 2 cycles.Results The efficiency of experimental group and control group were 30.0%and 26.7%,and disease control rates were 66.7%and 70.0%. There was no significant difference (P>0.05).Adverse reaction showed that grade Ⅲ-Ⅳleucopenia occurrence rates of the ex-perimental group and the control group were 13.3%(4/30) and 40.0%(12/30).The difference was statistically significant (P<0.05).GradeⅢ-Ⅳanemia incidence rates were 3.3%(1/30),and 6.7%(2/30),there was no significant difference (P>0.05);GradeⅢ-Ⅳthrombocytopenia occurrence rates were 6.7%(2/30),36.7%(11/30).The difference was statistical-ly significant(P<0.05).There was no statistical difference in liver and kidney function damage ,nausea and vomiting;the inci-dence of alopecia in experimental group and control group were 10.0%(3/30),and 33.3%(10/30),the difference was statisti-cal significant(P<0.05).Conclusion Pemetrexed combined with cisplatin is effective for advanced lung adenocarcinoma with tolerable side effects .

关 键 词：培美曲塞 吉西他滨 顺铂 化疗 

分 类 号：R734.2[医药卫生—肿瘤]