培美曲塞联合顺铂与标准TP方案用于肺腺癌患者术后化疗的近期疗效比较
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摘要
目的观察对比培美曲塞联合顺铂和标准多西紫杉醇联合顺铂(TP)方案用于肺腺癌患者术后化疗的近期疗效及不良反应。方法利用抽签法将76例行肺癌根治术的肺腺癌患者随机分为2组,各38例。A组实施培美曲塞联合顺铂方案,B组实施TP方案,均给予4周期化疗。比较2组临床疗效、3年无病生存率与中位无病生存期(DFS)、3年总生存率与中位总生存期(OS),并记录2组不良反应情况。结果化疗4周期后,A组总有效率34. 21%,与B组31. 58%比较,无统计学差异(P> 0. 05)。A组无病生存率(60. 53%)、中位DFS (25. 13个月)、总生存率(78. 95%)、中位OS(34. 75个月)与B组无病生存率(55. 26%)、中位DFS (24. 96个月)、总生存率(81. 58%)、中位OS(35. 18个月)比较,无统计学差异(P> 0. 05)。A组Ⅲ～Ⅳ级白细胞减少率(5. 26%)、Ⅲ～Ⅳ级中性粒细胞减少率(2. 63%)及Ⅲ～Ⅳ级脱发率(7. 89%)均明显低于B组(26. 32%)、(15. 79%)、(28. 95%),差异有统计学意义(P <0. 05);其他不良反应发生情况无明显差异(P> 0. 05)。结论肺腺癌术后采取培美曲塞联合顺铂和标准TP方案均能产生辅助化疗效果,且效果相当,其中培美曲塞联合顺铂引起的不良反应较轻,患者耐受性更好。
Objective To observe the short-term curative effect and adverse reactions of pemetrexed combined with cisplatin and standard docetaxel combined with cisplatin( TP) for postoperative chemotherapy in patients with lung adenocarcinoma.Methods 76 patients with lung adenocarcinoma who underwent radical surgery of lung cancer were randomly divided into 2 groups by sortition method,38 cases in each group. Group A was treated with pemetrexed combined with cisplatin plan,while group B was treated with TP plan. The two groups were given chemotherapy for 4 cycles. The clinical curative effect,3-year disease-free survival and median disease-free survival( DFS),3-year total survival rate and median overall survival( OS) were compared between the two groups. The adverse reactions in both groups were recorded. Results After 4 cycles,there was no significant difference in the total response rate between group A and group B( 34. 21% vs 31. 58%)( P > 0. 05). There were no significant differences between group A and group B in DFS rate,median DFS,total survival rate or median OS between group A and group B( 60. 53% vs 55. 26%,25. 13 months vs 24. 96 months,78. 95% vs 81. 58%,34. 75 months vs 35. 18 months)( P >0. 05). The rates of grade Ⅲ to Ⅳ leukopenia,grade Ⅲ to Ⅳ neutropenia and grade Ⅲ to Ⅳ hair loss in group A( 5. 26%,2. 63%,7. 89%) were significantly lower than those in group B( 26. 32%,15. 79%,28. 95%)( P < 0. 05),without significant differences in the other adverse reactions between the two groups( P > 0. 05). Conclusion Both pemetrexed combined with cisplatin and standard TP plan can produce effects of adjuvant chemotherapy after lung adenocarcinoma surgery. And their effects are similar. The adverse reactions caused by pemetrexed combined with cisplatin are relatively milder,and tolerance of patients is relatively better.
Objective To observe the short-term curative effect and adverse reactions of pemetrexed combined with cisplatin and standard docetaxel combined with cisplatin( TP) for postoperative chemotherapy in patients with lung adenocarcinoma.Methods 76 patients with lung adenocarcinoma who underwent radical surgery of lung cancer were randomly divided into 2 groups by sortition method,38 cases in each group. Group A was treated with pemetrexed combined with cisplatin plan,while group B was treated with TP plan. The two groups were given chemotherapy for 4 cycles. The clinical curative effect,3-year disease-free survival and median disease-free survival( DFS),3-year total survival rate and median overall survival( OS) were compared between the two groups. The adverse reactions in both groups were recorded. Results After 4 cycles,there was no significant difference in the total response rate between group A and group B( 34. 21% vs 31. 58%)( P > 0. 05). There were no significant differences between group A and group B in DFS rate,median DFS,total survival rate or median OS between group A and group B( 60. 53% vs 55. 26%,25. 13 months vs 24. 96 months,78. 95% vs 81. 58%,34. 75 months vs 35. 18 months)( P >0. 05). The rates of grade Ⅲ to Ⅳ leukopenia,grade Ⅲ to Ⅳ neutropenia and grade Ⅲ to Ⅳ hair loss in group A( 5. 26%,2. 63%,7. 89%) were significantly lower than those in group B( 26. 32%,15. 79%,28. 95%)( P < 0. 05),without significant differences in the other adverse reactions between the two groups( P > 0. 05). Conclusion Both pemetrexed combined with cisplatin and standard TP plan can produce effects of adjuvant chemotherapy after lung adenocarcinoma surgery. And their effects are similar. The adverse reactions caused by pemetrexed combined with cisplatin are relatively milder,and tolerance of patients is relatively better.
引文
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[9]马汉宸,隋东昕,徐少华.晚期肺腺癌培美曲塞联合顺铂化疗后应用培美曲塞同药维持治疗的临床疗效[J].山东医药,2016,56(33):99-101.
[10]陈毅鹏,陈小霞.PP方案和GP方案治疗晚期非小细胞肺癌的Meta分析[J].实用癌症杂志,2015,30(11):1633-1638.
[11]刘延霞,赵峰,王炳平.培美曲塞或多西紫杉醇联合顺铂治疗晚期NSCLC的临床疗效比较[J].中华肿瘤防治杂志,2015,22(15):1232-1234.
[12]马亚梅.培美曲塞联合顺铂治疗晚期非小细胞肺癌的疗效观察[J].实用癌症杂志,2015,30(2):205-207.
[13]陈华林,杨东红,王永存,等.培美曲塞+顺铂方案诱导化疗联合同期放化疗对局部晚期非小细胞肺癌的近期疗效及安全性观察[J].现代生物医学进展,2015,15(13):2487-2490.
[14]赵丹.培美曲塞或多西他赛联合顺铂二线治疗晚期非小细胞肺癌的疗效对比研究[J].实用临床医药杂志,2015,19(15):34-37.
[15]王卫军,李冬雷,李润浦.培美曲塞联合顺铂同步放化疗治疗局部晚期肺腺癌的近期疗效观察[J].临床肺科杂志,2015,20(2):236-238.
[16]Hanna N,Shepherd FA,Fossella FV,et al.Randomized phaseⅢtrial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy[J].Journal of Clinical Oncology,2004,22(9):1589-1597.
[17]梁亚海.培美曲塞和紫杉醇同期放化疗对局部晚期老年肺腺癌近期疗效的对比研究[J].广西医科大学学报,2016,33(3):537-539.
[18]Scagliotti GV,Kortsik C,Dark GG,et al.Pemetrexed combined with oxaliplatin or carboplatin as first-line treatment in advanced non-small cell lung cancer:a multicenter,randomized,phaseⅡtrial[J].Clinical Cancer Research An Official Journal of the American Association for Cancer Research,2005,11(2 Pt 1):690.
[2]宁涓,高桂华,胡立娟,等.培美曲塞治疗一线失败的晚期非鳞非小细胞肺癌的疗效观察[J].中国基层医药,2016,23(15):2339-2342.
[3]马国安.吉西他滨、培美曲塞、多西他赛联合顺铂治疗晚期肺腺癌的临床疗效研究[J].医学临床研究,2015,32(3):585-587.
[4]王莉,梁嵘,刘志辉,等.晚期肺腺鳞癌不同化疗方案疗效分析[J].西部医学,2016,28(6):840-844.
[5]邵扣凤,刘燕文.不同剂型紫杉醇联合顺铂治疗晚期非小细胞肺癌的效果分析[J].临床肿瘤学杂志,2016,21(10):893-897.
[6]韩冬,贺太平.影像学方法评估非小细胞肺癌临床疗效的应用现状及展望[J].实用放射学杂志,2016,32(7):1126-1129.
[7]武文娟,陈丽,蒋亚齐,等.培美曲塞联合顺铂治疗晚期肺腺癌的疗效观察[J].蚌埠医学院学报,2015,40(11):1529-1531.
[8]王岚,刘宝刚.培美曲塞与顺铂配伍治疗晚期肺腺癌132例疗效与安全性分析[J].陕西医学杂志,2015,44(9):1142-1144.
[9]马汉宸,隋东昕,徐少华.晚期肺腺癌培美曲塞联合顺铂化疗后应用培美曲塞同药维持治疗的临床疗效[J].山东医药,2016,56(33):99-101.
[10]陈毅鹏,陈小霞.PP方案和GP方案治疗晚期非小细胞肺癌的Meta分析[J].实用癌症杂志,2015,30(11):1633-1638.
[11]刘延霞,赵峰,王炳平.培美曲塞或多西紫杉醇联合顺铂治疗晚期NSCLC的临床疗效比较[J].中华肿瘤防治杂志,2015,22(15):1232-1234.
[12]马亚梅.培美曲塞联合顺铂治疗晚期非小细胞肺癌的疗效观察[J].实用癌症杂志,2015,30(2):205-207.
[13]陈华林,杨东红,王永存,等.培美曲塞+顺铂方案诱导化疗联合同期放化疗对局部晚期非小细胞肺癌的近期疗效及安全性观察[J].现代生物医学进展,2015,15(13):2487-2490.
[14]赵丹.培美曲塞或多西他赛联合顺铂二线治疗晚期非小细胞肺癌的疗效对比研究[J].实用临床医药杂志,2015,19(15):34-37.
[15]王卫军,李冬雷,李润浦.培美曲塞联合顺铂同步放化疗治疗局部晚期肺腺癌的近期疗效观察[J].临床肺科杂志,2015,20(2):236-238.
[16]Hanna N,Shepherd FA,Fossella FV,et al.Randomized phaseⅢtrial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy[J].Journal of Clinical Oncology,2004,22(9):1589-1597.
[17]梁亚海.培美曲塞和紫杉醇同期放化疗对局部晚期老年肺腺癌近期疗效的对比研究[J].广西医科大学学报,2016,33(3):537-539.
[18]Scagliotti GV,Kortsik C,Dark GG,et al.Pemetrexed combined with oxaliplatin or carboplatin as first-line treatment in advanced non-small cell lung cancer:a multicenter,randomized,phaseⅡtrial[J].Clinical Cancer Research An Official Journal of the American Association for Cancer Research,2005,11(2 Pt 1):690.