培美曲塞和顺铂联合同步放疗治疗局部晚期肺腺癌疗效观察  

Effects of Combined Therapy of Pemetrex and Cisplatin Combined with Radiotherapy in the Treatment of Advanced Lung Adenocarcinoma

作　　者：黄健[1] 黄东宁[1] 覃莉[1] 

机构地区：[1]广西医科大学第四附属医院(柳州市工人医院),广西柳州545005

出　　处：《医学临床研究》2016年第3期467-469,共3页Journal of Clinical Research

摘　　要：【目的】探讨培美曲塞联合顺铂（PC）方案同步放疗治疗晚期肺腺癌的·恪床效果。【方法】选取本院肿瘤科收治的98例晚期肺腺癌患者，随机分为研究组和对照组，每组各49例，研究组采用PC方案联合同步放疗治疗，对照组采用紫杉醇＋顺铂结合同步放疗治疗，观察比较两组患者的近期疗效、血清癌胚抗原（CEA）、鳞状细胞抗原（SCCAg）、糖抗原（CA125）、神经元特异性烯醇化酶（NSE）的变化及并发症发生情况，远期预后。【结果】研究组患者的缓解率为37．50％（18／48）、总有效率为81．25Voo（39／48），均显著高于对照组患者的25．53％（12／47）、65．96％（31／47），但两组相比较差异无显著性（P〉0．05）；治疗后研究组患者的血清CEA、SCCAg、CA125、NSE水平显著低于对照组，且差异有显著性（P〈0．05）；研究组的Ⅲ度、Ⅳ度骨髓抑制、消化道反应、皮疹、肝功能损害发生率显著低于对照组，且差异有显著性（P〈0．05）；研究组患者的中位生存时间为13．5个月显著长于对照组的10．3个月（P〈0．05）。【结论】PC方案联合同步放疗治疗晚期肺腺癌较紫杉醇＋顺铂联合放疗具有更好的效果和安全性。[Objective]Study clinical effects of pemetrex combined with cisplatin （PC） regimen combined for chemotherapy in the treatment of advanced lung adenocarcinoma. [Methods]Selected 98 patients in the Cancer Center of our hospital with advanced lung cancer. The patients were randomly divided into the observation group and control group; each with 49 patients. The observation group used the PC program with concurrent radiation treatment, while the control group received gemcitabine（change to taxol） and cisplatin combined with synchronous radiotherapy treatment. The short-term efficacy of the two groups before and after chemotherapy, serum carcinoembryonic antigen, post-operative complications, and long-term prognosis were analyzed and studied. [Results] Remission rate was 37.50 % in the observation group; the total efficiency rate was 81.25 %. This was significantly higher than the patients in the control group with 25.53 % remission rate, 65.96 % total efficiency rate. However, the difference was not statistically significant （ P 〉0.05）. The serum CEA, SCCAg, CA125, and NSE levels be- tween the two groups had significant difference （ P 〈0.05）. After treatment, the serum CEA, SCCAg, CA125, and NSE levels were significantly lower in the observation group than in the control group （ P 〈0.05）. Appearance of third and fourth degree bone marrow suppression, gastrointestinal reactions, rashes, and liver dysfunction was significantly lower in the observation group than in the control group and the difference was statistically significant （ P %0.05）. The observation group had a median survival time of 13.5 months, and was significantly longer than the 10.3 months in the control group （ P 〈0.05） （log-rank Х^2 =7.074, P =0.016〈0.05）. [Conclusion]PC program with concurrent chemotherapy in advanced lung cancer is much safer and provides superior results to gern＇citabine（change to taxol） combinated chemotherapy.

关 键 词：谷氨酸盐类/治疗应用 鸟嘌呤/类似物和衍生物 鸟嘌呤/治疗应用 顺铂/治疗应用 放射疗法 调强适形 肺肿瘤/治疗 腺癌/治疗 

分 类 号：R737.9[医药卫生—肿瘤]