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培美曲塞联合奈达铂治疗晚期肺腺癌临床疗效及其安全性观察
Clinical efficacy and safety of pemetrexed and nedaplatin in treatment of advanced lung adenocarcinoma
- 第三军医大学学报 2018年40卷第13期 页码：1236-1241
- 作者机构：
543001 广西 梧州，广西梧州市工人医院(广西医科大学第七附属医院)肿瘤科
- 作者简介：
[周健, E-mail:857446116@qq.com ZHOU Jian, E-mail:857446116@qq.com
- 基金信息：国家卫生计生委医药卫生科技发展研究中心课题(W2015PM010)
DOI：10.16016/j.1000-5404.201801020
中图分类号： R730.53;R734.2;R979.1收稿：2018-01-03，
修回：2018-03-29，
纸质出版：2018-07-15
- 稿件说明：
移动端阅览
周毅, 周健, 张莹, 等. 培美曲塞联合奈达铂治疗晚期肺腺癌临床疗效及其安全性观察[J]. 第三军医大学学报, 2018,40(13):1236-1241.
Yi ZHOU, Jian ZHOU, Ying ZHANG, et al. Clinical efficacy and safety of pemetrexed and nedaplatin in treatment of advanced lung adenocarcinoma[J]. Journal of Third Military Medical University, 2018, 40(13): 1236-1241.
周毅, 周健, 张莹, 等. 培美曲塞联合奈达铂治疗晚期肺腺癌临床疗效及其安全性观察[J]. 第三军医大学学报, 2018,40(13):1236-1241. DOI： 10.16016/j.1000-5404.201801020.
Yi ZHOU, Jian ZHOU, Ying ZHANG, et al. Clinical efficacy and safety of pemetrexed and nedaplatin in treatment of advanced lung adenocarcinoma[J]. Journal of Third Military Medical University, 2018, 40(13): 1236-1241. DOI： 10.16016/j.1000-5404.201801020.
摘要
目的
2
探讨培美曲塞联合奈达铂治疗晚期肺腺癌临床疗效及安全性。
方法
2
选择2015年4月至2017年12月本科收治的晚期肺腺癌患者，按照随机数字法分成对照组和观察组。观察组使用培美曲塞联合奈达铂方案治疗，对照组使用培美曲塞联合顺铂方案治疗。剔除失访病例后，共有60例患者完成本实验，观察组31例，对照组29例。对比两组患者的临床疗效及随访结果、药物毒副作用、体力状况变化、PS标准评分及生活质量评分。
结果
2
① 临床疗效及患者随访结果：对照组总有效率为37.93%；观察组总有效率为41.94%，观察组及对照组有效率比较差异无统计学意义(χ
2
=0.073，
P
=0.735)；两组中位无进展生存期及1年生存率比较，差异无统计学意义(
P
>
0.05)。②化疗药物毒副作用：在白细胞减少的发生率上观察组Ⅲ度以上患者显著比对照组低(
P
＜0.05)。观察组Ⅱ度以上恶心、呕吐发生率显著比对照组低(
P
＜0.05)。③2组治疗前后变化PS评分比较及肿瘤患者的生活质量(quality of life
QOL)评分比较差异无统计学意义(
P
>
0.05)。④治疗前后EORTC QLQ-C30评价比较：经过化学药物治疗之后，观察组患者总体的健康状态及一般情况(如困倦乏力、恶心、呕吐等)均明显优于对照组(
P
＜0.05)。
结论
2
培美曲塞联合奈达铂方案与培美曲塞联合顺铂方案的临床疗效在晚期肺腺癌的治疗中无明显差异，但前者副作用小，安全性高，培美曲塞联合奈达铂化疗方案在针对晚期肺腺癌的治疗上值得推广。
Abstract
Objective
2
To investigate clinical efficacy and safety of pemetrexed combined with nedaplatin in the treatment of advanced lung adenocarcinoma.
Methods
2
All patients with advanced lung adenocarcinoma treated in our hospital from April 2015 to April 2017 were recruited in this study. They were randomly divided into control group (pemetrexed combined with cisplatin) and observation group (pemetrexed combined with nedaplatin). After the patients lost in follow-up were eliminated
there were 60 patients finally subjected in this study
including 31 in the observation group and 29 in the control. The clinical efficacy
clinical outcome
toxic and side effects of chemical drugs
change of physical condition
performance status (PS
Zubrod-ECOG-WHO score)
and quality of life (QOL) were separately evaluated in the 2 groups after treatment.
Results
2
① Clinical efficacy and outcomes: There were no significant differences in overall response rate (37.93%
vs
41.94%
Chi
-square=0.072 0
P
=0.788 5)
median progression free survival (mPFS) or 1-year survival rate (
P
>
0.05) between the control and observation groups. ② Toxic and side effects of chemical drugs: The incidence rate of over grade Ⅲ leukocytopenia was significantly lower in the observation group than the control (9.68%
vs
27.59%
Chi
-square=4.251 2
P
=0.034 0). And the former group also had lower incidence rate of over grade Ⅱ nausea and vomiting (
P
<
0.05). ③ No significant differences were seen in PS score and QOL score in the both groups before and after the treatment (
P
>
0.05). ④ Evaluation an
d comparison of EORTC QLQ-C30 before and after treatment: though the QOL of the 2 groups were declined after the treatment of chemical drugs
but the total health and general situation (mental state
fatigue
nausea and vomiting) were significantly better in the observation group than the control group (
P
<
0.05).
Conclusion
2
Though there are no significant differences in clinical efficacy between pemetrexed combined with nedaplatin and with cisplatin in the treatment of advanced lung adenocarcinoma
and the former regimen has the advantages of milder side effects
higher safety and little impact on the QOL of patients. Therefore
it is worthy of popularizing widely in the treatment.
关键词
Keywords
references
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