CAJ | 학술논문

目的探讨培美曲塞和卡铂对比紫杉醇和卡铂方案联合同期放化疗治疗局部晚期非小细胞肺癌的疗效和毒副反应.方法 60例Ⅲ期非小细胞肺癌患者(ⅢA期39例,ⅢB期21例)随机分为两组,一组接受培美曲塞500 mg/m2,d1,卡铂AUC 5,d1,21天重复；另一组接受紫杉醇150 mg/m2,d1,卡铂AUC 5,d1,21天重复.两组患者化疗期间同时接受适形调强放疗,总剂量60～70Gy,同步放化疗结束后2～4周继续给予原化疗方案巩固2～3周期.结果培美曲赛联合卡铂组与紫杉醇联合卡铂组的疾病有效率分别为44.83％和29.03％,疾病控制率分别为79.31％和67.74％,差异有统计学意义(P＜0.05).培美曲赛组不良反应少见,两组的中位无进展生存分别为12.5个月和9.9个月,1年生存率分别为58.62％和48.39％,差异有统计学意义(P＜0.05).结论培美曲赛联合卡铂可作为Ⅲ期非小细胞肺癌患者同期放化疗期间的优选化疗方案,毒性可耐受,疾病控制率及生存率较紫杉醇联合卡铂方案明显提高.
목적 탐토배미곡새화잡박대비자삼순화잡박방안연합동기방화료치료국부만기비소세포폐암적료효화독부반응.방법 60례Ⅲ기비소세포폐암환자(ⅢA기39례,ⅢB기21례)수궤분위량조,일조접수배미곡새500 mg/m2,d1,잡박AUC 5,d1,21천중복；령일조접수자삼순150 mg/m2,d1,잡박AUC 5,d1,21천중복.량조환자화료기간동시접수괄형조강방료,총제량60～70Gy,동보방화료결속후2～4주계속급여원화료방안공고2～3주기.결과 배미곡새연합잡박조여자삼순연합잡박조적질병유효솔분별위44.83％화29.03％,질병공제솔분별위79.31％화67.74％,차이유통계학의의(P＜0.05).배미곡새조불량반응소견,량조적중위무진전생존분별위12.5개월화9.9개월,1년생존솔분별위58.62％화48.39％,차이유통계학의의(P＜0.05).결론 배미곡새연합잡박가작위Ⅲ기비소세포폐암환자동기방화료기간적우선화료방안,독성가내수,질병공제솔급생존솔교자삼순연합잡박방안명현제고.
Objective To observe the effect and clinical toxicity of pemetrexed combined with carboplatin versus paclitaxel combined with carboplatin with concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).Methods Total of 60 patients stage Ⅲ NSCLC (ⅢA 39 patients,ⅢB 21 patients) were randomly assigned into two groups.Pemetrexed combined with carboplatin group:accepted pemetrexed 500 mg/m2,d1,carboplatin AUC 5,d1,once every 21 days.Paclitaxel combined with carboplatin group:paclitaxel 150 mg/m2,d1,carboplatin AUC 5,d1,once every 21 days.Two groups both accepted 3-D conformal radiation therapy (3D-CRT) during chemotherapy.The total dose was 60 ～ 70 Gy.After radiation therapy,the patients were accepted 2 ～ 3 cycles of chemotherapy.Results The efficacy of pemetrexed combined with carboplatin and paclitaxel combined with carboplatin were 44.83％ and 29.03％ respectively.The disease control rates of two groups were 79.31％ and 67.74％ respectively.The differences were statistically significant (P＜0.05).The adverse reactions of pemetrexed group were rare.Two groups of median progression-free survival were 12.5 and 9.9 months respectively.1 year overall survival was 58.62％ and 48.39％ respectively.The differences were also significant (P＜0.05).Conclusion Pemetrexed combined with carboplatin can be used as stage Ⅲ NSCLC patients treated with concurrent chemoradiation regimens during optimization.Toxicity was tolerable.Pemetrexed group was better than paclitaxel group in disease control rates and survival.