Clinical Study On The Short-Efficacy And Side Effects Of DDP Or NDP Combined With Pemetrexed In First-Line Treatment Of Advanced Lung Adenocarcinoma

Objective: To retrospectively analyze the short-term efficacy and adverse reactions of pemetrexed combined with nedaplatin compared with pemetrexed combined with cisplatin in first-line treatment of advanced lung adenocarcinoma,and to explore the feasibility of nedaplatin in first-line treatment of advanced lung adenocarcinoma.Methods: a total of 64 newly treated patients with advanced lung adenocarcinoma admitted to the affiliated hospital of Qingdao university from May 2013 to February 2015 were selected.Patients who received pemetrexed combined with cisplatin or nedaplatin in the first line were evaluated by imaging examination after 2 cycles according to RECIST1.1 criteria.Results: There was no significant difference in the general condition of the 64 patients included in the study.In terms of efficacy,after 2 cycles of first-line treatment,the objective response rate(ORR)of pemetrexed combined with nedaplatin group(n=24)and pemetrexed combined with cisplatin group(n=40)was 25.00%vs 27.50%,P value was 0.826,indicating no significant difference between the two groups.The disease control rate(DCR)between the two groups was 91.70% compared with 85.00%(P =0.696),and there was no significant difference in DCR between the two groups.In terms of safety,the incidence of liver damage(41.70% vs.35.00%)and myelosuppression were similar in the two groups.In myelosuppression,the incidence of decreased hemoglobin was higher in both groups(58.30% vs.50.00%),and the incidence of decreased white blood cell was similar in the two groups(25.00%vs.27.50%).Platelet decline rates were consistent(12.50%vs.12.50%);The incidence of nausea and vomiting was high in the cisplatin group,and about half of the patients showed varying degrees of nausea and vomiting.The incidence of grade ⅰ and ⅱ nausea and vomiting in the nedaplatin group was similar to that in the cisplatin group(25.00%vs.32.50%),but there was no grade ⅲnausea and vomiting in the nedaplatin group,while 7.5% of patients in the cisplatin group had grade ⅲ nausea and vomiting,requiring infusion to replenish energy.No renal injury occurred in both groups.Conclusions: Nedaplatin combined with pemetrexed has similar short-term efficacy to cisplatin combined with pemetrexed in the chemotherapy of advanced lung adenocarcinoma,but the incidence of adverse reactions is different.The incidence of bone marrow suppression is higher in the nedaplatin group,mainly manifested as decreased hemoglobin,while the incidence of nausea and vomiting is higher in the cisplatin group.