PC和DC方案一线治疗晚期肺腺癌临床观察.docVIP

PC和DC方案一线治疗晚期肺腺癌临床观察 　　摘要：目的 比较培美曲塞（PEM）联合顺铂 （DDP）与多西他赛（DOC）联合顺铂（DDP）治疗晚期肺腺癌的临床疗效及不良反应。方法 将45例晚期肺腺癌（ⅢB-Ⅳ期）患者随机分为培美曲塞加顺铂组（PC组）和多西他赛加顺铂组（DC组）。治疗 3个周期后评价疗效及不良反应。结果 PC组疾病控制率为52%；DC组疾病控制率为50%。两组比较差异均无统计学意义 （均P0.05）。PC组Ⅲ-Ⅳ度骨髓抑制及胃肠道反应显著低于DC组（P0.05）。结论 培美曲赛联合顺铂治疗晚期肺腺癌的疗效与多西他赛联合顺铂的疗效相当，但不良反应发生率低，可优先考虑作为晚期肺腺癌患者的一线治疗。 　　关键词：晚期肺腺癌；一线化疗；培美曲塞；多西他赛；顺铂 　　Observation of Clinical Effect of First-line Chemotherapy by DC and PC Regimen in Advanced Lung Adenocacinoma 　　SUN Jing-ping，CAI Wei 　　（Department of Internal Medicine-Oncology，Wujiang District First Peoples Hospital，Suzhou 215200，Jiangsu，China） 　　Abstract：Objective To compare the clinical effect and adverse reactions in patients with advanced lung adenocacinoma treated with the regimen of pemetrexed in combination with cisplatin and docetaxel in combination with cisplatin. Methods Forty five patients were devided in two groups randomly. 25 patients were treated with the regimen of PC and other 20 patients were treated with the regimen of DC. Evaluation was performed at the end of 3 cycles. The short term effect and adverse reactions of the two groups were observed. Results Disease control rate in PC was 52%， and that in DC was 50%.The Difference between the two groups was not statistically significant（P0.05）. The myelosuppression（ⅢB-Ⅳ degree ）and gastrointestinal toxicities in PC group is lower than that in DC group（P0.05）. Conclusion The regimen of pemetrexed in combination with cisplatin and Docetaxel in combination with cisplatin are the same effect in lung adenocacinoma. The adverse reactions of PC group is lower， so it can be the first-line chemotherapy in advanced lung adenocacinoma. 　　Key words：Advanced lung adenocacinoma； First-line chemotherapy；Pemetrexed； Docetaxel； Cisplatin 　　肺癌的发病率和死亡率占恶性肿瘤首位[1]，且仍呈持续上升趋势，其中非小细胞肺癌（non-small cell lung cancer，NSCLC）约占肺癌的80%，其中肺腺癌约占50%。大部分肺癌患者确诊时已为ⅢB-Ⅳ期，全身化疗是晚期NSCLC的主要治疗手段。目前铂类与第三代细胞毒药物的两药联合是标准一线治疗方案[2]。本研究比较培美曲赛或多西他赛联合顺铂一线治疗晚期肺腺癌的临床疗效及不良反应。 　　1资料与方法 　　1.1一般资料 选择我院2012年01月～20