The Compairson Of Pemetrexed And Gemcitabine Plus Nedaplatin In The Treatment Of Advanced Non-small Cell Lung Cancer

Background and objective：The mainly treatment of advanced non-smallcell lung cancer patients is chemotherapy. At present, platinum-based two-drugcombination has become the accepted standard treatment programs at home andabroad, in recent years the3rd generation of new anticancer drugs made someprogress in treating non-small cell lung cancer, combined with platinumregimen extended the survival of advanced patients. Pemetrexed is amulti-target folate inhibition, with clear efficacy and low toxic side effects,which has been widely used in clinical practise in recent years. Nedaplatin isthe2nd generation platinum drugs, which the efficacy is close to the cisplatin,being with low renal toxicity and no need to hydrationed, widely used inclinical practise. For these reasons this article compared the efficacy andtoxicity of pemetrexed with nedaplatin with gemcitabine with nedaplatin inadvanced adenoma lung cancer patient, to providing a new idea for clinicalwork.Methods: We elected28advanced adenoma lung cancer patients whowere correspond the conditions, separated into pemetrexed/nedaplatin groupand the gemcitabine/nedaplatin group. Dexamethasone was given before thepemetrexed administrated for desensitization therapy, while treated with oralfolic acid and vitamin B12. Specific dose: Pemetrexed500mg/m2d1,nedaplatin80mg/m2d2-3. Gemcitabine/nedaplatin group specific dose:Gemcitabine1000mg/m2d1、d8, nedaplatin80mg/m2d2-3. The cycle programin each group was21days, evaluated after each two cycles, each patientcompleted at least two cycles of chemotherapy. At the same time giving the symptomatic treatment of liver protection, protection of gastric mucosa andantiemetic. Given recombinant human granulocyte colony stimulating factorand recombinant human interleukin-11according to the myelosuppression.Results:28patients finished108cycles of combination chemotherapy intotal, per patients completed3.9cycles of combination chemotherapy.13patients in pemetrexed/nedaplatin group and15patients in gemcitabine/nedaplatin group, the RRwere38.5%(5/13) and40.0%(6/15),while the DCRwere96.2%(9/13) and73.3%(11/15) separately. The statistical test were notstatistically different (P>0.05). Further analysis showed that previouslyuntreated patients in pemetrexed/nedaplatin program the DCR was33.3%(2/6),gemcitabine/nedaplatin program’s DCR was50.0%(4/8), for retreatmentpatients DCR in each groups were71.4%(5/7) and57.1%(4/7). The RR of thetransfer of organs in the pemetrexed/nedaplatin group were25.0%(2/8)and60.0%(3/5) separately in which the transter organs was less than three or morethan two., while in gemcitabine/nedaplatin group the RR were30.0%(3/10)and20.0%(1/5). The adverse events in two groups were bothmyelosuppression and gastrointestinal reactions, which in pemetrexed groupthe toxicity has a low incidence compared with gemcitabine group, andleukopenia and thrombocytopenia have a statistically significant difference (P<0.05).Conclusions: Both of the group that treated with pemetrexed/nedaplatinand gemcitabine/nedaplatin have a certain efficacy in the treatment ofadvanced non-small cell lung cancer,and their effects were similar, whether thepreviously untreated patients or retreatment of patients are given a certaindegree of clinical remission; Release rate was significantly lower forpemetrexed/nedaplatin program on the hematological toxicity compared with gemcitabine/nedaplatin program, specially the leukopenia andthrombocytopenia, pemetrexed/nedaplatin program is tolerated bettercompared with gemcitabine/nedaplatin program.