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目的:观察顺铂(DDP)+培美曲塞(PEM)与DDP+吉西他滨(GEM)联合化疗方案治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效和不良反应。方法:将2009-07-05-2011-12-16胜利油田中心医院收治的88例晚期NSCLC患者随机分为PC组45例和GC组43例。PC组:培美曲塞500 mg/m2,静脉滴入,d1;DDP75mg/m2,静脉滴入,d2~d4。GC组:吉西他滨1 000mg/m2,持续静脉滴入30min,d1、d8;DDP同PC组。比较两组的临床疗效和不良反应。结果:PC、GC组近期有效率分别为42.2%(19/45)和41.9%(18/43),差异无统计学意义,P=0.772;疾病控制率分别为84.4%(38/45)和81.40%(35/43),差异无统计学意义,P=0.857;中位生存期分别为11.1和10.7个月,差异无统计学意义,P=0.747;1年生存率分别为42.2%和39.5%,差异无统计学意义,P=0.807。不良反应均可耐受。PC和GC组白细胞减少分别为44.4%(20/45)和60.5%(26/43),差异有统计学意义,P=0.023;血小板减少分别为53.3%(24/45)和76.7%(33/43),差异有统计学意义,P=0.016。结论:培美曲塞或吉西他滨联合DDP治疗晚期NSCLC,疗效相似,但前者不良反应明显减少,可作为晚期NSCLC患者的一线治疗用药。
Objective: To observe the clinical efficacy and side effects of combination of cisplatin (DDP) + pemetrexed (PEM) with DDP + gemcitabine (GEM) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: Eighty-eight patients with advanced NSCLC who were treated at Shengli Oilfield Central Hospital from 2009-07-05-2011-12 were randomly divided into PC group (45 cases) and GC group (43 cases). PC group: pemetrexed 500 mg / m2, intravenous infusion, d1; DDP75mg / m2, intravenous infusion, d2 ~ d4. GC group: gemcitabine 1 000mg / m2, continuous intravenous infusion 30min, d1, d8; DDP with PC group. The clinical efficacy and adverse reactions of the two groups were compared. Results: The effective rates in PC and GC groups were 42.2% (19/45) and 41.9% (18/43) respectively, with no significant difference (P = 0.772) and the disease control rates were 84.4% (38/45) and 81.40% (35/43), the difference was not statistically significant (P = 0.857); the median survival time was 11.1 and 10.7 months respectively, with no significant difference (P = 0.747); the 1-year survival rates were 42.2% and 39.5 %, The difference was not statistically significant, P = 0.807. Adverse reactions can be tolerated. The leukopenia in PC and GC groups was 44.4% (20/45) and 60.5% (26/43), respectively, with a significant difference (P = 0.023). The thrombocytopenia was 53.3% (24/45) and 76.7% / 43), the difference was statistically significant, P = 0.016. Conclusion: Pemetrexed or gemcitabine combined with DDP in the treatment of advanced non-small cell lung cancer (NSCLC) has similar curative effect, but the former has a significant reduction in adverse reactions and can be used as first-line treatment for patients with advanced NSCLC.