摘要目的:探究治疗晚期非小细胞肺癌应用培美曲塞联合顺铂效果、安全性以及对患者1年生存率影响。方法:对我院2016年6月至2018年6月85例收治晚期非小细胞肺癌患者相关资料予以回顾性分析,将接受培美曲塞与多西他赛分别联合顺铂治疗患者纳入培美曲塞组(n=42)和多西他赛组(n=43)。比较两组患者近期疗效,治疗前后肿瘤标志物水平变化,毒副反应发生率,远期疗效。结果:培美曲塞组患者治疗有效率高于多西他赛组(54.76% VS 48.84%),差异比较无统计学意义(P>0.05),培美曲塞组患者疾病控制率显著高于多西他赛组(92.86% VS 81.40%;P<0.05);两组患者治疗后NSE与CA125等肿瘤标志物水平显著降低(P<0.05),治疗后培美曲塞组患者四种肿瘤标志物水平明显低于多西他赛组(P<0.05);培美曲塞组患者血小板减少、胃肠道不适、肝功能异常、贫血、白细胞减少毒副反应发生率均低于多西他赛组,各种毒副作用发生率除肝功能异常外差异具有统计学意义(P<0.05);两组患者半年病情进展转移率比较差异没有统计学意义(P>0.05),培美曲塞组1年病情进展转移率显著低于多西他赛组(P<0.05);应用Kaplan-Merier结果显示培美曲塞组患者1年生存率(78.6%)显著高于多西他赛组(53.5%)(Log-rankχ2=5.297,P<0.05)。结论:晚期非小细胞肺癌治疗应用培美曲塞联合顺铂近期有效率与多西他赛联合顺铂效果相当,但是其疾病控制率与远期疗效较好,并发症发生率低,可显著下调肿瘤标志物水平。
Abstract：Objective: To explore curative effect and safety of pemetrexed combined with cisplatin on advanced non-small cell lung cancer (NSCLC) and the influences on 1-year survival rate. Methods: A retrospective analysis was performed on related data of 85 patients with advanced NSCLC who were admitted to the hospital from June 2016 to June 2018. Patients who were treated with pemetrexed combined with cisplatin or docetaxel combined with cisplatin were included into pemetrexed group (n=42) and docetaxel group (n=43), respectively. The short-term curative effect, changes in tumor marker levels before and after treatment, incidence of toxicity, and long-term curative effect were compared between the two groups. Results: The response rate of treatment in pemetrexed group was higher than that in docetaxel group (54.76% vs 48.84% (P>0.05). The disease control rate in pemetrexed group was significantly higher than that in docetaxel group (92.86% vs 81.40%) (P<0.05). After treatment, levels of tumor markers such as NSE and CA125 in both groups were significantly decreased (P<0.05). After treatment, levels of four tumor markers in pemetrexed group were significantly lower than those in docetaxel group (P<0.05). The incidence of toxicity such as thrombocytopenia, gastrointestinal discomfort, abnormal liver function, anemia and leukopenia in pemetrexed group was lower than that in docetaxel group. There were significant differences in incidence of various toxicity except for abnormal liver function (P<0.05). There was no significant difference in metastatic rate of half a year disease progression between the two groups (P>0.05). The metastatic rate of 1-year disease progression in pemetrexed group was significantly lower than that in docetaxel group (P<0.05). Kaplan-Merier results showed that 1-year survival rate in pemetrexed group was significantly higher than that in docetaxel group (78.6% vs 53.5%). (Log-rank χ2= 5.297, P<0.05). Conclusion: The short-term effective rate of pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer is equivalent to that of docetaxel combined with cisplatin, but its disease control rate and long-term effect are better, and the incidence of complications is low, which can significantly reduce the level of tumor markers.
邱培, 张清峰, 陈林, 姚思美. 培美曲塞联合顺铂治疗晚期非小细胞肺癌疗效及对患者毒副反应及1年生存率的影响[J]. 河北医学, 2020, 26(3): 506-510.
QIU Pei, et al. Curative Effect of Pemetrexed Combined with Cisplatin on Advanced Non-small Cell Lung Cancer and the Influences onToxicity and 1-year Survival Rate. HeBei Med, 2020, 26(3): 506-510.
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2020, Vol. 26 
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