培美曲塞和吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床效果对比观察

杨海劲　吴剑　刘卓星

[摘要]目的 评价培美曲塞和吉西他滨联合卡铂治疗老年晚期非小细胞肺癌临床效果，探讨其临床适用性和优越性。 方法 选择从2013年6月～2015年12月于我院就诊的84例晚期非小细胞肺癌患者作为试验组，另选择从2011年6月～2013年12月的60例患者作为对照组，对照组采用吉西他滨联合卡铂的化疗方案，试验组则采用培美曲塞联合卡铂化疗方案。观察两组患者的化疗疗效及药物对血液毒性的影响。 结果 试验组患者的有效率为52.38%，对照组53.33%，两组比较差异无统计学意义（χ2=0.0127，P>0.05）；试验组患者的疾病控制率为88.10%，对照组86.67%（χ2=0.0653，P>0.05）。试验组患者各项血液指标出现异常的情况均低于对照组患者，差异有统计学意义（P<0.05）。 结论 培美曲塞联合卡铂在治疗老年晚期非小细胞肺癌方面可以达到和吉西他滨联合卡铂同样的效果，而且血液毒性小，安全性较高，适合临床长期推广应用。

[关键词]培美曲塞；吉西他滨；卡铂；老年；非小细胞肺癌

[中图分类号] R734.2 [文献标识码] B [文章编号] 2095-0616（2016）09-81-03

[Abstract] Objective To estimate the clinical effect of pemetrexed and gemcitabine combined with carboplatin in the treatment of elderly patients with advanced non-small cell lung cancer， and explore their clinical usability and superiorities. Methods 84 elderly patients with advanced non-small cell lung cancer who were in our hospital from June 2013 to December 2015 were selected as experimental group， another 60 patients during June 2011 and December 2013 were selected as control group. The control group received chemotherapy of gemcitabine and carboplatin， and the experimental group received chemotherapy of pemetrexed and carboplatin. The chemotherapy efficacy and drugs toxicities on blood of the two groups were analyzed and compared. Results The effective rate of the experimental group was 52.38%， while that of the control group was 53.33%， the difference was not statistical significant （χ2=0.0127， P>0.05）. The disease control rate of the experimental group was 88.10%， while that of the control group was 86.67% （χ2=0.0653， P>0.05）. The abnormal rate of blood indexes of the experimental group was lower than that of the control group， the difference was statistically significant （P<0.05）. Conclusion Compared with the therapy of gemcitabine and carboplatin， the chemotherapy of pemetrexed and carboplatin has the same efficacy in the treatment of elderly patients with advanced non-small cell lung cancer， moreover， it has smaller toxicities on blood， thus is safe and suitable for long-term clinical promotion.

[Key words] Pemetrexed； Gemcitabine； Carboplatin； Elderly patients； Non-small cell lung cancer

肺癌是威胁人类健康的重要疾病之一，也是我国发病率非常高的一类肿瘤疾病[1]。肺癌的临床常见的治疗方式就是手术及放化疗[2]。肺癌的病理类型很多，非小细胞肺癌就是其中之一，众多研究表明，非小细胞肺癌对化疗也比较敏感[3]。而我院此次就针对两组药物培美曲塞联合卡铂和吉西他滨联合卡铂在治疗非小细胞肺癌方面的疗效，重点是血液毒性情况开展了本次研究，现报道如下。

1 资料与方法

1.1 一般资料

选取我院接诊的84例晚期非小细胞肺癌患者作为试验组，另选择2011年6月～2013年12月的60例患者病例作为对照组。所有入选患者均经病理学明确诊断，肿瘤分期为ⅢB ～ Ⅳ期，且均经胸部 CT 检查确定。其中……