培美曲塞与吉西他滨分别联合卡铂对老年晚期NSCLC的疗效对比及安全性评价  

Comparison of the efficacy and safety of clinical trials of pemetrexed or gemcitabine combined with carboplatin in treatment of the elderly patients with advanced NSCLC

作　　者：朱彦博[1] 王振欣[1] 熊峰[1] 吴灵芝[1] 

机构地区：[1]苏州大学附属第一医院肿瘤科,江苏苏州215007

出　　处：《中国生化药物杂志》2014年第4期145-147,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：江苏省高校自然科学研究项目(13KJB320022)

摘　　要：目的探讨培美曲塞联合卡铂与吉西他滨联合卡铂对老年晚期非小细胞肺癌(Non-small-cell carcinoma,NSCLC)疗效及安全性。方法将128例老年NSCLC患者随机平均分为PC组和GC组(n=64)。PC组给予培美曲塞联合卡铂用药;GC组给予吉西他滨联合卡铂用药。2组患者经过2个周期以上的化疗后对比评价其疗效及安全性,指标包括治疗有效率,不良反应发生率,肺癌症状评分量表和远期疗效评价等。结果 2组患者经过化疗后,PC组治疗有效率为34.38%,GC组治疗有效率为31.25%,2者差异相比无统计学意义;化疗后,2组肺癌症状评分量表(Lung Cancer Symptom Scale,LCSS)差异比较无统计学意义。化疗后的毒副反应中恶心呕吐、脱发、白细胞减少、血小板减少和神经毒性的3级~4级不良发生率比较分别为,培美曲塞联合卡铂组6.25%、0、3.13%、4.67%、7.81%;吉西他滨联合卡铂组分别为17.18%、0、20.31%、15.63%、18.75%。以上2组数据比较(除脱发外),差异均具有统计学意义(P<0.05)。PC组患者的中位生存时间为12.1个月,1、2年生存率分别为46.2%和13.3%;GC组患者的中位生存时间为11.3个月,1、2年生存率分别为46.8%和12.5%。2组患者远期治疗效果的差别不具有统计学意义。结论培美曲塞联合卡铂或吉西他滨联合卡铂对老年晚期NSCLC的疗效相近,但培美曲塞联合卡铂的治疗方案可能更安全。Objective To explore the efficacy and the safety of clinical trials of pemetrexed combined with carboplatin and gemcitabine with carboplatin in treating advanced NSCLC of the elderly patients.Methods A total of one hundred and twenty-eight elderly patients with advanced NSCLC were randomly divided into two groups(n=64).The PC group in which patients were treated with pemetrexed combined with carboplatin,and the GC group in which patients were treated with gemcitabine combined with carboplatin.The effects and the safety were assessed by the following indexes, treatment efficiency,side effects,LCSS. Results The treatment efficiency of the PC group and the GC group were 34.38% and 31.25% after chemotherapy.The difference was no statistically significant between two groups.The difference of LCSS was no statistically significant between two groups.Except hair loss,the incidences of nausea and vomiting,leukopenia,thrombocytopenia and neurotoxicity (grade III-IV )in the PC group (6.25%,3.13%,4.67%,7.81%)were significant lower than those in the GC group(17.18%,20.31%,15.63%,18.75%)(P<0.05).The 1-year and 2-year survival rates of the PC and GC groups were 46.2% VS 46.8% and 13.3% VS 12.5%,respectively,with a median survival of 12.1 VS 1 1.3 months,without a statistically significant difference between two groups.Conclusion PC and GC show similar efficacy for elderly NSCLC patients,however,the toxicities in PC patients are lower than those in GC patients.Thus,pemetrexed combined with carboplatin is an effective therapeutic regimen for advanced NSCLC in elderly patients.

关 键 词：非小细胞肺癌 老年人 培美曲塞 吉西他滨 卡铂 联合治疗 治疗结果 

分 类 号：R743.2[医药卫生—神经病学与精神病学]