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目的探讨培美曲塞联合顺铂治疗晚期尿路上皮癌临床效果及对患者生存率的影响。方法选取2012年3月—2015年7月郑州市第三人民医院78例晚期尿路上皮癌患者,根据化疗方案分组各39例。对照组给予紫杉醇联合顺铂治疗,观察组给予培美曲塞联合顺铂治疗。对比两组临床疗效及不良反应发生率,随访1年,统计两组6个月生存率及1年生存率。结果观察组治疗总有效率41.03%、疾病控制率76.92%与对照组治疗总有效率43.59%、疾病控制率74.36%比较,差异无统计学意义(P>0.05);观察组骨髓抑制及脱发发生率与对照组比较,差异无统计学意义(P>0.05),周围神经病变、胃肠道反应、肌肉关节疼痛及过敏发生率均低于对照组,差异有统计学意义(P<0.05);观察组6个月生存率53.84%、1年生存率38.46%与对照组6个月生存率48.72%、1年生存率35.90%比较,差异无统计学意义(P>0.05)。结论培美曲塞联合顺铂方案治疗晚期尿路上皮癌,临床效果确切,具有较高安全性。
Objective To investigate the clinical effect of pemetrexed combined with cisplatin in the treatment of advanced urothelial carcinoma and its influence on the survival rate of patients. Methods From March 2012 to July 2015, 78 patients with advanced urothelial carcinoma in the Third People ’s Hospital of Zhengzhou City were enrolled and 39 patients were divided into groups according to the chemotherapy regimen. The control group was treated with paclitaxel combined with cisplatin, and the observation group was treated with pemetrexed combined with cisplatin. The clinical efficacy and incidence of adverse reactions were compared between the two groups. The patients were followed up for 1 year, and the 6-month survival rate and 1-year survival rate were calculated. Results The total effective rate of observation group was 41.03%, disease control rate was 76.92%, the control group was 43.59%, disease control rate was 74.36%, the difference was not statistically significant (P> 0.05); observation group, bone marrow suppression and hair loss occurred Compared with the control group, the difference was not statistically significant (P> 0.05). The incidence of peripheral neuropathy, gastrointestinal reaction, muscle and joint pain and allergy were all lower than those in the control group (P <0.05). The 6-month survival rate in the observation group was 53.84%, the one-year survival rate was 38.46%, and the 6-month survival rate in the control group was 48.72%. The 1-year survival rate was 35.90%. There was no significant difference (P> 0.05). Conclusion Pemetrexed combined with cisplatin regimen in the treatment of advanced urothelial carcinoma has definite clinical effect and high safety.