培美曲塞与多西他赛联合铂类一线治疗晚期肺腺癌的疗效比较

doi:10.3969/j.issn.1007-3969.2015.09.005

中国癌症杂志 ›› 2015, Vol. 25 ›› Issue (9): 671-676.doi: 10.3969/j.issn.1007-3969.2015.09.005

培美曲塞与多西他赛联合铂类一线治疗晚期肺腺癌的疗效比较

周　娟¹，贲素琴²

1. 南通大学附属医院呼吸科，江苏南通 226001 ；
2. 上海市第一人民医院呼吸科，上海200080

出版日期:2015-09-30 发布日期:2015-12-15
通信作者: 贲素琴　E-mail:bensuqin@163.com

The clinical effects of pemetrexed or docetaxel combined with cisplatin as the first line treatment for advanced lung adenocarcinoma

ZHOU Juan¹, BEN Suqin²

1.Department of Respiratory Medicine, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China; 2.Department of Respiratory Medicine, Shanghai General People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China

Published:2015-09-30 Online:2015-12-15
Contact: BEN Suqin E-mail: bensuqin@163.com

摘要/Abstract

摘要： 背景与目的：目前，晚期肺腺癌主要依靠以化疗为主的综合治疗。培美曲塞作为一种多靶点抗叶酸制剂，与铂类药物联合应用治疗晚期肺腺癌，因其疗效好、不良反应轻而受到推崇。本研究比较培美曲塞与多西他赛联合铂类一线治疗晚期肺腺癌的效果及不良反应。方法：将50例晚期肺腺癌患者随机分为培美曲塞＋顺铂(PC)组和多西他赛＋顺铂(TP)组。每组各25例患者。PC组：培美曲塞500 mg/m²静脉滴注，第1天；顺铂75 mg/m²静脉滴注，第1天。TP组：多西他赛75 mg/m²静脉滴注，第1天；顺铂75 mg/m²静脉滴注，第1天。两组1个周期均为21 d。比较两组的有效率(response rate，RR)、疾病控制率(disease control rate，DCR)、无进展生存期(progression-free survival，PFS)和总生存期(overall survival，OS)。测定外周血T淋巴细胞亚群活性，评价两组患者免疫功能。结果：50例患者均可评价疗效及不良反应，两组均无完全缓解(complete remission，CR)病例，部分缓解(partial remission，PR)20例，疾病稳定(stable disease，SD)17例，疾病进展(progressive disease，PD)13例。PC组与TP组的RR、DCR、PFS和OS差异均无统计学意义(P>0.05)。PC组治疗后与TP组相比，CD3^＋、CD4^＋、CD4^＋/CD8^＋T细胞和NK细胞活性均升高，CD8^＋T细胞活性降低，但差异无统计学意义(P＞0.05)。两组的不良反应主要为骨髓抑制和消化道反应，PC组Ⅲ~Ⅳ级不良反应白细胞减少、血小板减少、消化道症状和乏力的发生率低于TP组，差异有统计学意义(P<0.05)。结论：培美曲塞与多西他赛联合顺铂治疗晚期肺腺癌的临床疗效相当，但前者可降低不良反应发生率。

关键词: 肺腺癌, 培美曲塞, 多西他赛, 化疗

Abstract: Background and purpose: At present, the advanced lung adenocarcinoma is mainly treated by chemotherapy-oriented comprehensive therapy. Pemetrexed as a multi-target antifolate chemotherapeutic drug, combined with platinum, was approved for treatment of advanced lung adenocarcinoma because of its low toxicity and high efficacy. The purpose of this study was to compare the short-term clinical efficacy and toxicity of pemetrexed and docetaxel combined with cisplatin for advanced lung adenocarcinoma. Methods: Fifty patients with stage Ⅲ-Ⅳ lung adenocarcinoma were randomly divided into two groups. Group PC received pemetrexed (500 mg/m², d1) combined with cisplatin (75 mg/m², d1) and group TP received docetaxel (75mg/ m², d1) combined with cisplatin (75 mg/m², d1) treatment. One cycle was 21 days in both two groups. The response rate (RR), disease control rate (DCR), progressionfree survival (PFS) and overall survival (OS) of the two groups were compared. The peripheral blood T lymphocyte subsets and natural killer (NK) cell activity of patients in both groups were measured before and after the treatment, while compared with healthy controls (25 cases). Results: Among 50 patients, no one got complete remission (CR), 20 patients got partial remission (PR), 17 patients had stable disease (SD) and 13 patients had progressive disease (PD). It showed no significant difference in RR, DCR, PFS and OS (P>0.05) between two groups. Compared with group TP, the activity of CD3⁺, CD4⁺, CD4⁺/CD8⁺ T cells and NK cells increased and CD8⁺ T cells reduced in group PC after treatment, but the value had no obvious change (P>0.05). The common side effects were hematological toxicity and gastrointestinal response. The incidence of side effects in group PC was lower than that in group TP, and the degree was also slighter (P<0.05). Conclusion: The clinical efficacy of pemetrexed combined with cisplatin is equal to docetaxel combined with cisplatin in treatment of advanced lung adenocarcinoma, but the former could reduce the adverse reaction rate.

Key words: Lung adenocarcinoma, Pemetrexed, Docetaxel, Chemotherapy

周　娟,贲素琴. 培美曲塞与多西他赛联合铂类一线治疗晚期肺腺癌的疗效比较[J]. 中国癌症杂志, 2015, 25(9): 671-676.

ZHOU Juan, BEN Suqin. The clinical effects of pemetrexed or docetaxel combined with cisplatin as the first line treatment for advanced lung adenocarcinoma[J]. China Oncology, 2015, 25(9): 671-676.

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培美曲塞与多西他赛联合铂类一线治疗晚期肺腺癌的疗效比较

The clinical effects of pemetrexed or docetaxel combined with cisplatin as the first line treatment for advanced lung adenocarcinoma

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