培美曲塞联合顺铂与标准TP方案用于肺腺癌患者术后化疗的近期疗效比较  

Short-term Curative Effect of Pemetrexed Combined with Cisplatin and Standard TP Plan on Postoperative Chemotherapy for Patients with Lung Adenocarcinoma

作　　者：张旭宇[1] 李润浦 王艳丽[1] 李冬杰[1] ZHANG Xuyu;LI Runpu;WANG Yanli(Baoding Second Central Hospital,Baoding,072750)

机构地区：[1]河北省保定市第二中心医院,072750

出　　处：《实用癌症杂志》2019年第5期770-773,共4页The Practical Journal of Cancer

摘　　要：目的观察对比培美曲塞联合顺铂和标准多西紫杉醇联合顺铂(TP)方案用于肺腺癌患者术后化疗的近期疗效及不良反应。方法利用抽签法将76例行肺癌根治术的肺腺癌患者随机分为2组,各38例。A组实施培美曲塞联合顺铂方案,B组实施TP方案,均给予4周期化疗。比较2组临床疗效、3年无病生存率与中位无病生存期(DFS)、3年总生存率与中位总生存期(OS),并记录2组不良反应情况。结果化疗4周期后,A组总有效率34. 21%,与B组31. 58%比较,无统计学差异(P> 0. 05)。A组无病生存率(60. 53%)、中位DFS (25. 13个月)、总生存率(78. 95%)、中位OS(34. 75个月)与B组无病生存率(55. 26%)、中位DFS (24. 96个月)、总生存率(81. 58%)、中位OS(35. 18个月)比较,无统计学差异(P> 0. 05)。A组Ⅲ～Ⅳ级白细胞减少率(5. 26%)、Ⅲ～Ⅳ级中性粒细胞减少率(2. 63%)及Ⅲ～Ⅳ级脱发率(7. 89%)均明显低于B组(26. 32%)、(15. 79%)、(28. 95%),差异有统计学意义(P <0. 05);其他不良反应发生情况无明显差异(P> 0. 05)。结论肺腺癌术后采取培美曲塞联合顺铂和标准TP方案均能产生辅助化疗效果,且效果相当,其中培美曲塞联合顺铂引起的不良反应较轻,患者耐受性更好。Objective To observe the short-term curative effect and adverse reactions of pemetrexed combined with cisplatin and standard docetaxel combined with cisplatin( TP) for postoperative chemotherapy in patients with lung adenocarcinoma.Methods 76 patients with lung adenocarcinoma who underwent radical surgery of lung cancer were randomly divided into 2 groups by sortition method,38 cases in each group. Group A was treated with pemetrexed combined with cisplatin plan,while group B was treated with TP plan. The two groups were given chemotherapy for 4 cycles. The clinical curative effect,3-year disease-free survival and median disease-free survival( DFS),3-year total survival rate and median overall survival( OS) were compared between the two groups. The adverse reactions in both groups were recorded. Results After 4 cycles,there was no significant difference in the total response rate between group A and group B( 34. 21% vs 31. 58%)( P > 0. 05). There were no significant differences between group A and group B in DFS rate,median DFS,total survival rate or median OS between group A and group B( 60. 53% vs 55. 26%,25. 13 months vs 24. 96 months,78. 95% vs 81. 58%,34. 75 months vs 35. 18 months)( P >0. 05). The rates of grade Ⅲ to Ⅳ leukopenia,grade Ⅲ to Ⅳ neutropenia and grade Ⅲ to Ⅳ hair loss in group A( 5. 26%,2. 63%,7. 89%) were significantly lower than those in group B( 26. 32%,15. 79%,28. 95%)( P < 0. 05),without significant differences in the other adverse reactions between the two groups( P > 0. 05). Conclusion Both pemetrexed combined with cisplatin and standard TP plan can produce effects of adjuvant chemotherapy after lung adenocarcinoma surgery. And their effects are similar. The adverse reactions caused by pemetrexed combined with cisplatin are relatively milder,and tolerance of patients is relatively better.

关 键 词：培美曲塞 顺铂 多西紫杉醇 肺腺癌 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]