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目的比较培美曲塞联合顺铂方案与紫杉醇联合顺铂方案治疗晚期肺腺癌的近期疗效及不良反应。方法对2009年1月-2012年12月收治入院的Ⅲ~Ⅳ期肺腺癌患者,根据患者意愿分为培美曲塞联合顺铂组(PP组)63例和紫杉醇联合顺铂组(TP组)61例,每组完成2个周期化学治疗(化疗)后进行疗效评价。结果 PP组和TP组有效率分别为58.7%、37.7%,疾病控制率分别为74.6%、52.5%,中位无进展生存期分别为6.1、4.5个月,两组比较差异均有统计学意义(P<0.05)。PP组的恶心呕吐、白细胞减少发生率低于TP组,差异有统计学意义(χ2=16.164,P<0.001;χ2=9.469,P=0.002);血小板减少、贫血、肝肾功能损害发生率两组差异有统计学意义(χ2=0.098,P=0.755;χ2=0.267,P=0.606;χ2=0.006,P=0.973)。结论对于肺腺癌,培美曲塞联合顺铂方案较紫杉醇联合顺铂有更好的近期疗效,且不良反应较轻。
Objective To compare the short-term efficacy and adverse reactions of pemetrexed combined with cisplatin and paclitaxel combined with cisplatin in the treatment of advanced lung adenocarcinoma. Methods Patients with stage III-IV lung adenocarcinoma who were admitted to hospital from January 2009 to December 2012 were divided into pemetrexed plus cisplatin group (PP group) and paclitaxel plus cisplatin group (TP) according to patient’s wishes. Group) 61 patients, each group completed 2 cycles of chemotherapy (chemotherapy) after the efficacy evaluation. Results The effective rates in the PP and TP groups were 58.7% and 37.7%, the disease control rates were 74.6% and 52.5%, and the median progression-free survival time was 6.1 and 4.5 months respectively. There was a statistically significant difference between the two groups. (P<0.05). The incidence of nausea, vomiting and leukopenia in the PP group was lower than that in the TP group (,2=16.164, P<0.001; χ2=9.469, P=0.002); the incidence of thrombocytopenia, anemia, and liver and kidney damage was two. The difference was statistically significant (χ2=0.098, P=0.755; χ2=0.267, P=0.606; χ2=0.006, P=0.973). Conclusion For lung adenocarcinoma, pemetrexed combined with cisplatin has better short-term efficacy than paclitaxel plus cisplatin, and the adverse reactions are mild.