Efficacy and safety of pemetrexed combined with nedaplatin or cisplatin in the treatment of advanced non-small cell lung cancer

Abstract

Objective To observe the clinical efficacy and adverse reactions of pemetrexed in combination with nedaplatin or cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC). Methods 85 patients with stage Ⅲ B/IV NSCLC diagnosed by pathology or cytology were randomly divided into two groups by random double blind method.The study group(45cases) was treated with pemetrexed combined with nedaplatin, and the control group(40cases) was given pemetrexed combined with cisplatin chemotherapy.The specific method was pemetrexed 500mg/m2, the first day of intravenous infusion, cisplatin 75mg/m2 or nedaplatin 80mg/m2, divided into 3 times, the 2nd, 3rd, 4th day, intravenous infusion, every 21d for a cycle.At the end of the chemotherapy, the efficacy and adverse reaction were analyzed.The patients were followed up to record no progress survival and one-year survival rate. Results Among 85 patients, there were 35 cases of partial remission(PR), 35 cases of stable(SD) and 15 cases of progression(PD), the total effective rate(ORR) was 42.2%, the disease control rate(DCR) was 82.2%.There were no statistically significant differences in ORR and DCR between the two groups(χ2=0.043, 0.001, all P>0.05). As to the adverse reactions, the incidence rates of the decreased number of white blood cells (42.2% vs.25.0%), the decreased number of neutrophils (35.6% vs.17.5%), the decreased number of platelets (42.2% vs.15.0%), anemia(31.1% vs.12.5%), nausea/vomiting(22.2% vs.70.0%) between the two groups had statistically significant differences (χ2=9.319, 4.664, 7.559, 4.226, 19.556, all P 0.05). Conclusion There was no statistically significant difference in the efficacy between pemetrexed combined with nedaplatin or cisplatin, non-squamous cell carcinoma patients get a better therapeutic effect.Nedaplatin is more likely to cause myelosuppression and intestinal side effects of cisplatin are more common. Key words: Carcinoma, non-small-cell lung; Pemetrexed; Nedaplatin; Cisplatin