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目的比较培美曲塞联合顺铂与多西他赛联合顺铂一线治疗晚期肺腺癌的近期疗效、无进展生存期及毒副反应。方法 76例晚期肺腺癌(ⅢB/Ⅳ期)患者随机分为培美曲塞联合顺铂(PC)组和多西他赛联合顺铂(DC)组,每组各38例。PC组:培美曲塞500mg/m2,d1;DC组:多西他赛75mg/m2,d1。两组顺铂均为25mg/m2,d1～3;每21d为1个周期。两组均治疗2周期后评价疗效及毒副反应。对所有患者的近期疗效、1年生存率、无进展生存期及毒副反应进行随访及组间比较。结果 PC组近期有效率为42.1%,中位无进展生存期6.9月,1年生存率55.3%;DC组近期有效率为36.8%,中位无进展生存期6.2月,1年生存率47.4%;两组比较差异均无统计学意义(P均>0.05)。PC组患者Ⅲ～IV度血液学毒性发生率明显低于DC组患者(P<0.05)。结论培美曲塞联合顺铂一线治疗晚期肺腺癌有稳定的疗效,更低的毒副反应。
Objective To compare the short-term curative effect, progression-free survival and toxicity of pemetrexed combined with cisplatin and docetaxel plus cisplatin in the treatment of advanced lung adenocarcinoma. Methods Sixty-six patients with advanced lung adenocarcinoma (stage ⅢB / Ⅳ) were randomly divided into pemetrexed combined with cisplatin (PC) group and docetaxel combined with cisplatin (DC) group, 38 cases in each group. PC group: pemetrexed 500mg / m2, d1; DC group: docetaxel 75mg / m2, d1. Two groups of cisplatin were 25mg / m2, d1 ~ 3; every 21d for a cycle. Two groups were treated after 2 cycles to evaluate the efficacy and toxicity. All patients in the short-term efficacy, 1-year survival rate, progression-free survival and toxicity were followed up and compared between groups. Results The effective rate of PC was 42.1%, the median progression-free survival was 6.9% and the one-year survival rate was 55.3%. The recent effective rate was 36.8% in DC group, and the median progression-free survival time was 6.2 months. The 1-year survival rate was 47.4% There was no significant difference between the two groups (P> 0.05). The incidence of grade Ⅲ ~ IV hematologic toxicity in PC group was significantly lower than that in DC group (P <0.05). Conclusion Pemetrexed plus cisplatin in the treatment of advanced lung adenocarcinoma has a stable efficacy and lower toxicity.