Clinical Observation Pemetrexed Combined With Cisplatin As First-line Treatment Of Advanced Lung Adenocarcinoma

Background: The lung cancer is the most common malignant tumor in China ,the growth of lung cancer was 26.9% per year in our country, to the 21st century, lung cancer mortality in China has risen to the top of cancer mortality ,in which of the non-small- cell lung cancer ,NSCLC makes up about 80~85%.Due to the hiding of the onset and the lack of specificity in clinical manifestation,60%-70% patients has been in middle and late period when diagnosis is conformed and miss the chance of cure, combined chemotherapy of advanced non-small-cell lung cancer is the primary means of treatment, chemotherapy can prolong patients'survival and improve their quality of life. Advanced non-small cell lung cancer chemotherapy to standard first-line platinum-based joint program of three generations of new drugs effects has reached the current platform. Tumor cells are all heterogeneous. We are in the actual clinical work can not be fixed for each chemotherapy treatment patterns , in patients with treatment should be individualized, based on their histological type and physical condition of the patients choose the most appropriate chemotherapy.Objective: The aim of this article is to explore the pemetrexed combined with cisplatin and docetaxel combined with cisplatin treatment of advanced lung cancer clinical efficacy and toxicity of comparison.Methods: A total of 37 chemotherapy-native patients with stage IIIB or IV NSCLC were enrolled in first Affiliated Hospital of Dalian Medical University and all of these patients had been confirmed with pathology or cytology. The age of patients was from 49 to 74 years old, median age was 61 ,male 24 cases and female 13 cases , IIIB 22 cases and iv 15 cases and all of their physical fitness score is≤2. There were 17 cases for pemetrexed combined with cisplatin(Group PC)(pemetrexed 500mg/㎡ add 100ml of normal saline and ivgtt in 10 to 30 minutes ,cisplatin 75mg/㎡ ,ivgtt, day 1 to 3,repeated every 21 days); 20 cases for docetaxel combined with cisplatin (Group TP)(docetaxel 75mg/m2, ivgtt, day 1, cisplatin 75mg/m2, ivgtt, day 1to3, repeated every 21 days). And there were comparability of data among the two groups. Evaluated after chemotherapy used in conjunction clinical efficiency,and were observed in the treatment of advanced lung adenocarcinoma of the efficacy and safety. Progression-free survival time was performed by Kaplan-Meier method and log-rank test, P<0.05 was considered as significant by SPSS 16.0.Results: PC Group has completed a total of 91 cycles chemotherapy, an average of 5.4 cycles (2 to 8 cycles), TP Group has completed 90 cycles, an average of 4.5cycles (2 to 7 cycles). In the Group PC disease control rates was respectively 47.1 %, in group TP was respectively15.0 %, there is significant differences between the two groups (P<0.05). In the Group PC Progress free survival (PFS) was 4.9 months, in group TP was 4.4 months. There were no significantly statistical differences in the two groups (P>0.05). The most common toxicities were: arrest of bone marrow and alimentary tract reaction. The incidence of bone marrow suppression were respectively 29.4%,75%, there were significantly statistical differences in the two groups (P<0.05). The incidence of alimentary tract reaction were respectively 41.2%,75%, there were significantly statistical differences in the two groups (P<0.05).The arrest of bone marrow over degreeⅢrespectively in Group PC was 5.9 %, while in the Group TP was 40 %, there were significantly statistical differences in the two groups (P<0.05). The alimentary tract reaction over degreeⅢrespectively in Group PC was 5.9 %, while in the Group TP was 10 %, there were no significantly statistical differences in the two groups (P>0.05).Conclusion: Regardless of pemetrexed or docetaxel combined with cisplatin chemotherapy as treatment of advanced lung adenocarcinoma for the patients with good conditions is effective, but with docetaxel compared pemetrexed plus cisplatin , the toxicities such as the arrest of bone marrow and alimentary tract reaction is smaller, so can be used as advanced lung adenocarcinoma and poor general condition advanced non-small cell lung cancer patients preferred fist–line treatment .