培美曲塞与吉西他滨联合卡铂治疗初治老年晚期肺腺癌的临床观察  

Efficacy of Pemetrexed or Gemcitabine Combined with Carboplatin in the Treatment of Elderly Patients with Advanced Lung Adenocarcinoma

作　　者：林劲冠[1] 石朝晖[1] 崔自重 余智渊[1] 何喆[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院日间化疗科,湖南长沙410013

出　　处：《现代生物医学进展》2014年第27期5257-5259,5263,共4页Progress in Modern Biomedicine

基　　金：湖南省卫生厅科研计划资助项目(B2013-101)

摘　　要：目的:比较培美曲塞与吉西他滨联合卡铂治疗初治老年晚期肺腺癌的疗效和安全性。方法:收集2010年1月-2011年12月我院≥65岁的Ⅲb期和Ⅳ期肺腺患者84例,随机分为培美曲塞联合卡铂(PC)组:培美曲塞500 mg/m2d1,卡铂按曲线下面积(Auc)=5的剂量水平d2;吉西他滨联合卡铂(GC)组:吉西他滨1000 mg/m2d1,8,卡铂按Auc=5的剂量水平d2,两组1个治疗周期均为21 d,每组42例,比较两组患者的有效率,不良反应及1、2年生存率。结果:PC组和GC组总有效率分别为28.6%和19%(P<0.05),疾病控制率分别为73.8%和57.1%(P<0.05);两组的中位PFS分别为11.8个月和10.2个月(P>0.05),1年生存率分别为52.3%和51.2%(P>0.05),2年生存率分别为24.1%和22.4%(P>0.05);PC组患者白细胞减少、贫血及血小板减少的不良反应发生率均明显低于GC组(P<0.05)。结论:培美曲塞联合卡铂与吉西他滨联合卡铂对初治老年晚期肺腺癌的疗效相近,但前者可能更安全;PC方案可作为老年晚期肺腺癌有效的一线化疗方案。Objective： To compare the efficacy and safety of pemetrexed or gemcitabine combined with carboplatin in the treatment of elderly patients with advanced lung adenocarcinoma. Methods： From January 2010 to December 2011 in our hospital, 84 elderly patients（≥65） with stage Ⅲ b and Ⅳ lung adenocarcinoma were collected, and randomly divided into pemetrexed plus carboplatin group（PC） with 42 cases and gemcitabine plus carboplatin group（GC） with 42 cases. PC group was received pemetrexed 500 mg /m2d1 and carboplatin in the area under the curve（Auc） of =5 d2, whereas GC group was recieved gemcitabine 1000 mg/m2d1,8,and carboplatin at a dose of Auc=5 level d2. One treatment cycles were 21 days. The efficiency, adverse reactions and 1, 2 year survival rate were compared. Results： The total effective rates in PC group and GC group were 28.6% and 19%（P〈0.05） respectively. The disease control rates were 73.8% and 57.1%（P〈0.05）. The median PFS were 11.8 and 10.2 months（P〈0.05）.1 year survival rates were 52.3% and51.2%（P〈0.05）. 2 years survival rates were 24.1% and 22.4%（P〈0.05）. In the PC group,？leukopenia, anemia and thrombocytopenia were significantly lower than those in the GC group（P〈0.05）. Conclusion： The efficacy of pemetrexed or gemcitabine combined with carboplatin in the treatment of elderly patients with advanced lung adenocarcinoma was roughly similar, but the former may be less adverse reactions. Therefore pemetrexed combined with carboplatin can be used as a safe and effective drug for clinical first-line treatment for the elderly patients with advanced lung adenocarcinoma.

关 键 词：肺腺癌 培美曲塞 吉西他滨 卡铂 

分 类 号：R734.2[医药卫生—肿瘤]