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中国临床研究:2017,30(9):1178-1181
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培美曲塞联合奈达铂与联合顺铂治疗晚期非小细胞肺癌的有效性及安全性比较
(凉山彝族自治州第一人民医院肿瘤科,四川 西昌 615000)
Efficacy and safety of pemetrexed combined with nedaplatin compared with pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer
(Oncology Department, People′s Hospital of Yi Autonomous Prefecture of Liangshan, Liangshan,Sichuan 615000,China)
摘要
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投稿时间:2017-03-20   网络发布日期:2018-03-23
中文摘要: 目的:对比在晚期非小细胞肺癌(NSCLC)治疗中采用培美曲塞联合奈达铂和培美曲塞联合顺铂的有效性和安全性。方法:纳入2011年10月至2013年10月60例晚期NSCLC患者作为研究对象,抽签法随机分为两组,各30例。观察组行培美曲塞联合奈达铂方案治疗(静脉滴注培美曲塞剂量500 mg/m2,奈达铂剂量75 mg/m2,辅以叶酸、地塞米松口服,维生素B12肌内注射,注意水化),对照组行培美曲塞联合顺铂方案治疗(培美曲塞剂量方法同观察组,联合顺铂75 mg/m2静脉滴注,辅以甘露醇、氯化钾、生理盐水,充分水化)。两组均以3周为1个周期,共治疗4~6个周期。随访记录两组患者无病进展时间(PFS)和2年生存率,比较两组治疗期间不良反应和生活质量变化情况。结果:治疗4周期后进行疗效评定,观察组PFS显著高于对照组[(7.52±1.47)个月vs(5.01±0.91)个月,P<0.01],2年生存率稍高于对照组,但差异无统计学意义(36.67% vs 16.67%,P>0.05)。生活质量评分观察组治疗期间较治疗前无明显变化(P>0.05);对照组则显著低于治疗前(P<0.01),且治疗中各周期均显著低于观察组同周期(P<0.05,P<0.01)。观察组贫血、脱发及血小板下降等药物不良反应发生率显著低于对照组(P<0.01,P<0.05)。结论:培美曲塞联合奈达铂用于晚期NSCLC较联合顺铂疗效更好,可显著延长PFS,有助于改善患者生存期,且不良反应少,对患者生活质量无显著影响,安全性高。
Abstract:Objective To compare the efficacy and safety of pemetrexed combined with nedaplatin with pemetrexed combined with cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC). Methods Sixty cases of advanced NSCLC patients from October 2011 to October 2013 were select as study objects. All patients were randomly divided into two groups (30 cases each) through the lottery method. The observation group received pemetrexed combined with nedaplatin therapy (intravenous infusion of pemetrexed 500 mg/m2 and nedaplatin 75 mg/m2, supplemented by oral folic acid, dexamethasone, intramuscular injection of vitamin B-12, pay attention to the hydration). The control group received pemetrexed combined with cisplatin therapy (the dose and method of pemetrexed was same as observation group, combined with intravenous infusion of cisplatin 75 mg/m2, supplemented with mannitol, potassium chloride, normal saline, and fully hydrated). Both groups were treated with 4 to 6 cycles (3 weeks a cycle). The progression free survival (PFS) and 2-year survival rate were recorded in the two groups, and the adverse reactions and quality of life were compared between the two groups. Results After 4 cycles of treatment the PFS of observation group was longer than control group [(7. 52±1. 47) m vs (5. 01±0.91) m, P<0.01], but there was no statistical difference between two groups in the 2-year survival(36. 67% vs 16. 67%, P>0.05). Before and after the treatment, there was no significant change in observation group′s quality of life (P>0.05); While in the control group, quality of life score was lower than pretreatment(P<0.01), and the score was lower than observation group at the same period in the treatment (P<0.05, P<0.01). The incidence of adverse reactions (such as anemia, alopecia, and platelet descend) was significantly lower in the observation group than in the control group (P<0.05, P<0.01). Conclusion In the treatment for advanced NSCLC, pemetrexed combined with nedaplatin could have a better curative effect than combined with cisplatin, which could prolong PFS significantly and help to improve patient′s survival time. While it has fewer adverse reactions and higher safety, which have no significant effect on the quality of life of patients.
文章编号:     中图分类号:R734.2    文献标志码:A
基金项目:国家卫生计生委医药卫生科技发展研究中心课题(W2015PM009)
引用文本:
黎启菊,刘娱,边界,陈方红.培美曲塞联合奈达铂与联合顺铂治疗晚期非小细胞肺癌的有效性及安全性比较[J].中国临床研究,2017,30(9):1178-1181.

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