杨锭洪 林长裕 黄晓龙

[摘要]目的 探讨培美曲塞联合奈达铂化疗在晚期肺腺癌患者治疗中的应用效果。方法 选取2014年2月～2015年2月我院肿瘤内科收治的60例晚期肺腺癌患者作为研究对象，随机分为治疗组与对照组，每组各30例。对照组采用吉西他滨联合奈达铂化療，治疗组采用培美曲塞联合奈达铂化疗，比较两组患者的治疗总有效率、治疗前后血清肿瘤标志物水平及不良反应发生情况，门诊或电话随访4～24个月，记录两组患者的总生存时间。结果 治疗组患者的治疗总有效率为63.33%，高于对照组的36.67%（P<0.05）;治疗组患者治疗后的血清癌胚抗原（CEA）、糖分解烯醇酶（NSE）、糖链抗原50（CA50）、糖类抗原199（CA199）水平均低于对照组（P<0.05）;治疗组患者脱发、皮疹、白细胞减少、中性粒细胞减少、血小板减少、肝肾功能损伤、恶心呕吐的发生率均低于对照组（P<0.05）;治疗组患者的总生存时间为（18.56±4.67）个月，长于对照组的（14.29±4.72）个月（P<0.05）。结论 培美曲塞联合奈达铂化疗治疗晚期肺腺癌的效果显著，可以有效改善血清肿瘤标志物水平，延长生存时间。

[关键词]肺腺癌化疗;培美曲塞;吉西他滨;奈达铂

[中图分类号] R979.1          [文献标识码] A          [文章编号] 1674-4721（2019）6（b）-0061-04

[Abstract] Objective To explore the application effects of Pemetrexed combined with Nedaplatin chemotherapy in the treatment of patients with advanced lung adenocarcinoma. Methods A total of 60 patients with advanced lung adenocarcinoma treated in department of medical oncology of our hospital from February 2014 to February 2015 were selected as the subjects， and randomly divided into treatment group and control group， with 30 cases in each group. The control group was treated with Gemcitabine combined with Nedaplatin chemotherapy， and the treatment group was given Pemetrexed combined with Nedaplatin chemotherapy. The effective rate of treatment， serum tumor marker levels before and after treatment and occurrence of adverse reactions were compared between the two groups. Patients were given 4 to 24 months of outpatient or telephone follow-up， and the overall survival time was recorded of the two groups. Results The total effective rate of treatment in treatment group （63.33%） was higher than that in control group （36.67%） （P<0.05）. The levels of serum carcinoembryonic antigen （CEA）， neuron-specific enolase （NSE）， carbohydrate antigen 50 （CA50） and carbohydrate antigen （CA199） in treatment group were lower than those in control group after treatment （P<0.05）. The incidence rates of alopecia， rash， leukopenia， neutropenia， thrombocytopenia， liver and kidney function damage and nausea and vomiting in treatment group were lower than those in control group （P<0.05）. The overall survival time in treatment group was （18.56±4.67） months， which was longer than that in control group （[14.29±4.72] months） （P<0.05）. Conclusion Pemetrexed combined with Nedaplatin chemotherapy has significant efficacy in the treatment of advanced lung adenocarcinoma， and it can effectively improve serum tumor markers levels and prolong survival time.

[Key words] Lung adenocarcinoma chemotherapy; Pemetrexed; Gemcitabine; Nedaplatin

肺腺癌病灶多数起始于支气管黏膜上皮，发病者以女性与非吸烟者多見，发病年龄一般较低[1]。此病初期症状并不明显，多数患者X线检查发现肺部占位性病变时已发展为癌症晚期，错过最佳手术时机[2]。培美曲塞是一种抑制癌症细胞复制的抗叶酸药剂，适用于非小细胞肺癌，奈达铂是一种毒副作用低的高效广谱抗癌化疗药物，研究显示两药联合使用可延长患者的存活时间，且不易产生耐药性[3]。本研究选取我院收治的60例晚期肺腺癌患者作为研究对象，分别给予培美曲塞联合奈达铂化疗以及吉西他滨联合奈达铂化疗，比较两种治疗方案的效果，现报道如下。

1资料与方法

1.1一般资料

选取2014年2月～2015年2月我院肿瘤内科收治的60例晚期肺腺癌患者作为研究对象，随机分为治疗组与对照组，每组各30例。……