摘要
目的观察培美曲塞联合顺铂治疗晚期非鳞状非小细胞肺癌(NSCLC)的临床效果。方法选取2023年1月—2024年12月福州大学附属省立医院收治的晚期非鳞状NSCLC患者80例,以随机数字表法分为培美曲塞组和紫杉醇组,每组40例。培美曲塞组采用培美曲塞联合顺铂治疗,紫杉醇组采用紫杉醇联合顺铂治疗,21 d为1个治疗周期,治疗3个周期。比较2组近期疗效,治疗前后肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段(CYFR21-1)、神经元特异性烯醇化酶(NSE)]、症状评分、生活质量[欧洲癌症研究与治疗生命质量量表(EORTC QLQ-C30)评分]、不良反应。结果培美曲塞组与紫杉醇组疾病控制率比较差异无统计学意义(77.50%vs.80.00%,χ^(2)=0.075,P=0.785)。治疗3个周期后,2组CEA、CYFR21-1、NSE水平均低于治疗前(P<0.01),组间比较差异无统计学意义(P>0.05);2组咳嗽、胸痛、呼吸困难、咯血评分均低于治疗前(P<0.01),组间比较差异无统计学意义(P>0.05);培美曲塞组EORTC QLQ-C30评分高于治疗前及紫杉醇组(P<0.01),紫杉醇组EORTC QLQ-C30评分与治疗前比较差异无统计学意义(P>0.05)。培美曲塞组不良反应总发生率低于紫杉醇组(10.00%vs.30.00%,χ^(2)=5.000,P=0.025)。结论培美曲塞联合顺铂治疗晚期非鳞状NSCLC的效果与紫杉醇联合顺铂基本相当,均可降低肿瘤标志物水平,缓解症状,但培美曲塞联合顺铂的不良反应少,有助于患者获得更好的生活质量。
Objective To observe the clinical efficacy of pemetrexed combined with cisplatin in the treatment of a dvanced non-squamous non-small cell lung cancer(NSCLC).Methods A total of 80 patients with advanced non-squamous NSCLC admitted to Provincial Hospital Affiliated to Fuzhou University from January 2023 to December 2024 were selected and divided into pemetrexed group and paclitaxel group by random number table method,with 40 cases in each group.Pemetrexed group was treated with p emetrexed combined with cisplatin,and paclitaxel group was treated with paclitaxel combined with cisplatin.Twenty-one days was one treatment cycle and they were treatment 3 cycles.The short-term efficacy,tumor markers(CEA,CYFR21-1,NSE),symptom score,quality of life(EORTC QLQ-C30 score)before and after treatment,and adverse reactions were compared between the two groups.Results There was no significant difference in d isease control rate between pemetrexed group and paclitaxel group(77.50%vs.80.00%,χ^(2)=0.075,P=0.785).After three cycles of treatment,the levels of CEA,CYFR21-1 and NSE in two groups were lower than before treatment(P<0.01),there was no statistical significance between groups(P>0.05).Scores of cough,chest pain,dyspnea and hemoptysis in two groups were lower than before treatment(P<0.01),there was no significant difference between groups(P>0.05).The EORTC QLQ-C30 score of pemetrexed group was higher than that before treatment and paclitaxel group(P<0.01),but there was no significant difference in EORTC QLQ-C30 score between paclitaxel group and before treatment(P>0.05).The overall incidence of adverse re actions in pemetrexed group was lower than that in paclitaxel group(10.00%vs.30.00%,χ^(2)=5.000,P=0.025).Co nclusion The effect of pemetrexed combined with cisplatin in the treatment of advanced non-squamous NSCLC is basically e quivalent to that of paclitaxel combined with cisplatin,both of which can reduce tumor marker levels and alleviate symptoms,but pemetrexed combined with cisplatin has fewer adverse reactions and helps patients to achieve better quality o f life.
作者
柯江容
KE Jiangrong(Anhai Hospital of Jinjiang,Fujian Province,Jinjiang 362212,China)
出处
《临床合理用药》
2025年第16期8-11,共4页
Chinese Journal of Clinical Rational Drug Use
基金
福建中医药大学2023年度校管课题(XB2023196)。
关键词
非鳞状非小细胞肺癌
晚期
培美曲塞
顺铂
肿瘤标志物
Non-squamous non-small cell lung cancer,advanced
Pemetrexed
Cisplatin
Tumor markers
