【摘要】 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。更多还原

【Abstract】 Objective To compare the clinical efficacy,progression-free survival( PFS) time and toxicity of pemetrexed combined with cisplatin and docetaxel combined with cisplatin in treating advanced lung adenocarcinoma. Methods Seventy-six patients with advanced lung adenocarcinoma( stage ⅢB / Ⅳ) were enrolled in this study. These patients were randomly divided into two groups (n= 38 each) : PC group ( pemetrexed plus cisplatin) and DC group( docetaxel plus cisplatin) . Patients in the PC group were administered with 500 mg/m2 pemetrexed on day 1,and patients in the DC group were administered with 75 mg / m 2 docetaxel on day 1. Both groups were given cisplatin 25 mg / m 2 on day 1,2 and 3. The treatments were repeated every 21 days. The short term efficacy and toxicity of patients were all evaluated after two cycles. PFS time and 1-year survival rate of all patients were followed up and compared between groups. Results The short-term total effective rate of the PC group and the DC group were 42. 1% and 36. 8% respectively; median PFS time was 6. 9 months in the PC group and 6. 2 months in the DC group; one-year survival rate was 55. 3% in PC group and 47. 4% in DC group. There was no significant difference of short term efficacy,median PFS time and 1-year survival rate between the two groups( all P > 0. 05) . The incidence of hematologic toxicities of the grade ⅢB / Ⅳ in the PC group was less than that in DC group( P < 0. 05) . Conclusions As the first-line treatment of advanced lung adenocarcinoma,pemetrexed combined with cisplatin has more stable efficacy and lower toxicity as compared to docetaxel combined with cisplatin.更多还原