The Clinical Study Of Pemetrexed Combined With Cisplatin For The First-line Treatment Of Advanced Non-small Cell Lung Cancer

Objective:To observe the recent efficacy and untoward effect of pemetreced combined with cisplatin as the first-line treatment of advanced non-small cell lung cancer and compare with the TP project comprised of gemcitabine and cisplatin. By further analyzing, to evaluate the difference of pemetreced treatment effect between squamous carcinoma and adenocarcinoma.Methods:46 patients with advanced non-small cell lung cancer were randomly divided into A group and B group.26 patients of A group accepted pemetreced combined with cisplatin project:pemetreced 500mg/m2 on day 1 and cisplatin 25mg/m2 on day 1,day 2 and day 3. Folic acid tablets were taken from a week before pemetreced is administered until 21 days after pemetreced was last used. A week before chemotherapy started, Vit B12 1000ug was given by intramu-scular injection and repeated every three weeks. The previous day, the same day and the second day, dexamethasone was given,4mg every time, two times one day.20 patients of B group accepted gemcitabine combined with cisplatin project:gemcitabine 1g/m2 on day 1 and day 8, cisplatin 25mg/m2 on day 1,day 2 and day 3. Treatment cycle was 21 days and effect was evalutated at least two cycles.Results:The effective rate was 42.31% of A group and 45% of B group, without significant difference (P=0.857).The desease controlled rate was 92.31% of A group and 95% of B group, without significant difference (P=0.717). The TTP and MST of two group had no significant difference either(6.4months VS 6.0months and 10.3 months VS 11.2 months).The rate of leukocyte reducing was 19.23% in A group and 50% in B group, with significant differences (P=0.029); The rate of blood platelet reducing was 3.85% in A group and 30% in B group, with significant differences(P=0.042); The rate of naupathia and vomit was 7.69% in A group and 40% in B group, with significant differences (P=0.023); Other toxic reactions, such as lipsotrichia, tetter, liver toxic, there was no significant difference.The result of further analyzing accoding to pathology type:Total effective rate was 50% of adenocarcinama group and 33.3% of squamous carcinoma group,without significant difference (P=0.4);The desease controlled rate was 92.9% of adenocarcinama group and 83.3% of squamous carcinoma group, without significant difference (P=0.457). The TTP and MST of two group was 7.9months VS 4.9months and 12.6 months VS 7.3 months, adenocarcinama group was obviously further than squamous carcinoma group(P<0.05).Conclusion:As the first-line treatment of advanced non-small cell lung cancer, pemetreced combined with cisplatin has the similar effect rate and survival time, lower toxicity than gemcitabine combined with cisplatin. The effective rate of squamous carcinoma and adenocarcinoma treated by pemetreced is similar, but the survival time of adenocarcinoma is further than squamous carcinoma.