The clinical effects of pemetrexed or docetaxel combined with cisplatin as the first line treatment for advanced lung adenocarcinoma / 中国癌症杂志

ABSTRACT

Background and purpose:At present, the advanced lung adenocarcinoma is mainly treated by chemotherapy-oriented comprehensive therapy. Pemetrexed as a multi-target antifolate chemotherapeutic drug, combined with platinum, was approved for treatment of advanced lung adenocarcinoma because of its low toxicity and high efifcacy. The purpose of this study was to compare the short-term clinical efifcacy and toxicity of pemetrexed and docetaxel combined with cisplatin for advanced lung adenocarcinoma.Methods:Fifty patients with stageⅢ-Ⅳ lung adenocarcinoma were randomly divided into two groups. Group PC received pemetrexed (500 mg/m2, d1) combined with cisplatin (75 mg/m2, d1) and group TP received docetaxel (75mg/ m2, d1) combined with cisplatin (75 mg/m2, d1) treatment. One cycle was 21 days in both two groups. The response rate (RR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) of the two groups were compared. The peripheral blood T lymphocyte subsets and natural killer (NK) cell activity of patients in both groups were measured before and after the treatment, while compared with healthy controls (25 cases).Results:Among 50 patients, no one got complete remission (CR), 20 patients got partial remission (PR), 17 patients had stable disease (SD) and 13 patients had progressive disease (PD).It showed no signiifcant difference in RR, DCR, PFS and OS (P>0.05) between two groups. Compared with group TP, the activity of CD3+, CD4+, CD4+/CD8+ T cells and NK cells increased and CD8+ T cells reduced in group PC after treatment, but the value had no obvious change (P>0.05). The common side effects were hematological toxicity and gastrointestinal response. The incidence of side effects in group PC was lower than that in group TP, and the degree was also slighter (P<0.05).Conclusion:The clinical efifcacy of pemetrexed combined with cisplatin is equal to docetaxel combined with cisplatin in treatment of advanced lung adenocarcinoma, but the former could reduce the adverse reaction rate.