Effect Analysis Of Pemetrexed Disodium Single As Second-line Chemotherapy In Advanced Non-squamous Non-small Cell Lung Cancer

Objective: From observation of pemetrexed disodium as second-line monotherapyfor advanced non-squamous non-small cell lung caner(NSCLC),to explore its efficacyand safety. Meanwhile to explore the correlation between serum thymidylate synthase(TS) expression and the efficacy.Methods:48patients was recruited who were diagnosed by pathology or cytologyand always had a line of platinum-based treatment in the advanced non-squamousnon-small cell lung cancer patients from January to December in2010. By random,positive parallel control,patients were divided into trial group and control group. Thetrial group was the Pemetrexed disodium group, dose of500mg/m2, the first day,oraldexamethasone and folic and muscle injection of vitamin B12to relieve adversereaction; The control group is Docetaxel group, dose of75mg/m2, the first day, andoral dexamethasone reduce adverse reaction; Two groups of every21days for atreatment cycle,4cycle for drug research and treatment cycle. Observe the twogroups of safety and efficacy, and follow-up time to March30,2012. All patientsunderwent enzyme linked immunosorbent assay (ELISA) for the serum thymidylatesynthase (TS) content, to further explore the correlation between serum TS expressionand the efficacy of non-squamous non-small cell lung cancer patients.Results:(1) All48patients completed the second-line monotherapy, Pemetrexeddisodium group25cases, Docetaxel group23cases;(2) the RR of Pemetrexeddisodium group and the Docetaxel group is12.0%and8.6%(P>0.05).The CBR is60.0%and52.2%(P>0.05). The median survival time without disease progresswere3.3months and3.0months (P>0.05).(3)The adverse reactions of two groupsare mainly bone marrow suppression, fatigue, gastrointestinal reaction. The adversereaction of Pemetrexed disodium group is less than the Docetaxel group, and thefatigued rate and hair loss rate of which is less than the Docetaxel group(P <0.05),which has statistically significant. In FACT-L quality of life score, the Pemetrexeddisodium group is better than the Docetaxel group.(4) Use ELISA method to determin TS of patients,the Pemetrexed disodium group is75.79±51.89pg/ml whilethe Docetaxel group is75.68±60.20pg/ml, there were no significant differencesbetween the two group(P>0.05).(5) The mean serum TS leve of disease controlgroup patients of is less than the progress patients.They were57.27±38.05pg/mland99.38±59.07pg/ml in the Pemetrexed disodium group,which has a statisticallysignificant difference (P=0.041).Conclusion:(1)The clinical curative effect in non-squamous non-small cell lungcancer is Pemetrexed disodium group better than Docetaxel group,but they hasn’tstatistically difference.(2) But the Pemetrexed disodium group has less adversereaction, life quality of life is better than the Docetaxel group.(3)It is regarded thatthe serum TS contentration may be as an index of clinical therapeutic effecacy andprognosis prediction.