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目的评价培美曲塞联合顺铂治疗老年晚期非小细胞肺癌(NSCLC)的有效性和安全性。方法选择我院在2010年5月到2013年12月所收治的45例老年晚期不可手术的Ⅲb期和Ⅳ期NSCLC患者接受培美曲塞(PEM)联合顺铂(DDP)与吉西他滨(GEM)联合顺铂(DDP)的随机、双盲、临床对照研究。研究的终点目标是有效率(RR)、肿瘤进展时间(TTP)、中位生存期(MST)、1年生存率以及毒性反应。结果 5个周期的化疗有后,PEM组有效率为43.5%,中位TTP6.2个月,中位生存时间8.9个月,1年生存率50.0%,与对照组组间比较差异无统计学意义(P>0.05);在毒性等不良反应的发生率上,PEM组明显低于GEM组,组间比较差异有统计学意义(P<0.05)。结论 PEM组和GEM组治疗老年晚期非小细胞肺癌近期临床疗效可,中位TTP和生存时间及1年生存率差异不大,但PEM组耐受性及毒性反应低于GEM组。PEM联合DDP方案可作为老年晚期NSCLC有效的化疗方案。
Objective To evaluate the efficacy and safety of pemetrexed combined with cisplatin in the treatment of elderly patients with advanced non-small cell lung cancer (NSCLC). Methods Forty-five patients with stage Ⅲb and Ⅳ NSCLC who were admitted to our hospital from May 2010 to December 2013 were enrolled in this study. Pemetrexed (PEM) combined with cisplatin (DDP) and gemcitabine (GEM) Combined with cisplatin (DDP) randomized, double-blind, controlled clinical study. The endpoints of the study were efficiency (RR), tumor progression time (TTP), median survival (MST), 1-year survival, and toxicity. Results After 5 cycles of chemotherapy, the effective rate of PEM group was 43.5%, the median TTP was 6.2 months, the median survival time was 8.9 months, and the 1-year survival rate was 50.0%. There was no significant difference between the two groups (P> 0.05). In the incidence of adverse reactions such as toxicity, PEM group was significantly lower than GEM group, the difference was statistically significant (P <0.05). Conclusion The clinical efficacy of PEM and GEM in the treatment of elderly patients with advanced non-small cell lung cancer may be as short as possible. There is no significant difference between the median TTP and survival time and 1-year survival rate. However, the tolerability and toxicity of PEM group and GEM group are lower than those of GEM group. PEM combined with DDP regimen can be used as an effective chemotherapy regimen for elderly patients with advanced NSCLC.