培美曲赛与吉西他滨治疗晚期非小细胞肺癌患者的临床研究  

Clinical trial of pemetrexed and gemcitabine in the treatment of patients with non-small cell lung cancer

作　　者：周瑞清[1] 杨瑞青[1] 刘斌[1] 郑法德[1] 赵军[1] 周俭[2] 任传利 ZHOU Rui-qing;YANG Rui-qing;LIU Bin;ZHENG Fa-de;ZHAO Jun;ZHOU Jian;REN Chuan-li(Department of Respiratory and Critical Care Medicine,Fuyang People’s Hospital,Fuyang 236000,Anhui Province,China;Department of Oncology,Fuyang People’s Hospital,Fuyang 236000,Anhui Province,China;Clinical Laboratory Centre,Jiangsu Subei People’s Hospital,School of Clinical Medicine,Yangzhou University,Yangzhou 225001,Jiangsu Province,China)

机构地区：[1]阜阳市人民医院呼吸与危重症医学科,安徽阜阳236000 [2]阜阳市人民医院肿瘤科,安徽阜阳236000 [3]扬州大学临床医学院、江苏省苏北人民医院临床检验中心,江苏扬州225001

出　　处：《中国临床药理学杂志》2020年第14期1979-1982,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81573220)。

摘　　要：目的观察培美曲赛与吉西他滨治疗晚期非小细胞肺癌(NSCLC)患者的临床疗效。方法将97例晚期NSCLC患者随机分为对照组(48例)和试验组(49例)。对照组给予培美曲赛500 mg·m^-2,第1天,静脉滴注,卡铂5 mg·mL^-1·min^-1,第1天,静脉滴注;试验组给予吉西他滨1000 mg·m^-2,第1,8天,静脉滴注,卡铂5 mg·mL^-1·min^-1,第1天,静脉滴注。2组1个化疗周期均为21 d,连续化疗4~6个周期。比较2组患者化疗后的近期疗效、蛋白表达水平及药物不良反应发生情况。结果治疗后,对照组和试验组的总有效率分别为62.50%,47.83%,差异无统计学意义(P>0.05)。治疗后,对照组和试验组血清前梯度蛋白2(AGR2)分别为(7.30±2.76),(7.82±2.42)ng·mL^-1,癌胚抗原(CEA)分别为(8.84±3.02),(9.40±3.31)ng·mL^-1,人细胞角蛋白21-1片段分别为(7.20±2.20),(8.04±2.48)ng·mL^-1,神经特异性烯醇化酶(NSE)分别为(18.44±3.16),(19.62±3.84)ng·mL^-1,差异均无统计学意义(均P>0.05)。化疗过程中,对照组的恶心呕吐、骨髓抑制发生情况较试验组更轻,差异有统计学意义(P<0.05)。结论培美曲赛与吉西他滨分别联合卡铂治疗晚期NSCLC效果差异不大,对血清AGR2、CEA、CYFRA21^-1、NSE水平影响差异不大,但是培美曲赛化疗的药物不良反应发生率低。Objective To observe the clinical effect of pemetrexed and gemcitabine in the treatment of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 97 patients with advanced NSCLC were randomly divided into control group(48 cases)and treatment group(49 cases).Control group was given pemetrexed 500 mg·m^-2,on the first day,intravenous drip,carboplatin 5 mg·mL^-1·min^-1,day 1,intravenous infusion.Treatment group was given gemcitabine 1000 mg·m^-2,on days 1 and 8,intravenous infusion,carboplatin 5 mg·mL^-1·min^-1,first 1 day,intravenous drip.The two groups were all 21 d a cycle,and consecutive for 4-6 cycles of chemotherapy.The short-term efficacy,the expression of protein and adverse drug reactions after chemotherapy were compared between the two groups.Results After treatment,the total efficacy in control group and treatment group were 62.50%,47.83%,with no significant difference(P>0.05).After chemotherapy,the serum pre-gradient protein(AGR2)in control group and treatment group were(7.30±2.76),(7.82±2.42)ng·mL^-1,carcinoembryonic antigen(CEA)were(8.84±3.02),(9.40±3.31)ng·mL^-1,soluble fragment of cytokeratin 19(CYFRA21-1)were(7.20±2.20),(8.04±2.48)ng·mL^-1,neuron-specific enolase(NSE)were(18.44±3.16),(19.62±3.84)ng·mL^-1,all with no statistical difference(all P>0.05).During chemotherapy,the incidence of nausea and vomiting and bone marrow suppression in control group were less than those in treatment group,and the difference was statistically significant(P<0.05).Conclusion The effects of pemetrexed and gemcitabine combined with carboplatin in the treatment of advanced NSCLC are similar,but pemetrexed has a milder adverse drug reaction.

关 键 词：培美曲赛 吉西他滨 晚期非小细胞肺癌 

分 类 号：R979.1[医药卫生—药品]