Comparison of pemetrexed or paclitaxel combined with oxaliplatin treatment as a chemotherapy strategy for postoperative patients / 重庆医学

ABSTRACT

Objective To compare the therapeutic efficacies and toxicities either of pemetrexed or paclitaxel combined with oxaliplatin as a chemotherapy in postoperative with non‐small‐cell lung cancer(NSCLC) .Methods The clinical data collected from 86 patients who admitted into the first affiliated hospital of Kunming medical university from January 2010 to December 2011 who had been diagnosed with non‐small‐cell lung cancer(NSCLC) were retrospectively analyzed .All of these patients received the radical resection of pulmonary carcinoma ,in which 65 patients received pemetrexed combined with oxaliplatin treatment(named as peme‐trexed combination group) .Another 40 patients were treated with paclitaxel combined with oxaliplatin (named as paclitaxel combi‐nation group) .Survival analysis was evaluated by Kaplan‐Merie .Single factor analysis and COX regression model were employed to analyze the relationship between the influencing factors and the prognosis of disease .Results We found that neither OS (χ2 =0 .648 ,P=0 .421) nor PFS(χ2 =0 .758 ,P=0 .384)was statistical different between two groups .However ,the incidence of leucope‐nia above Ⅲ degrees was 34 .8% in pemetrexed combination group ,and 60 .0% in paclitaxel combination group(χ2 = 5 .469 ,P=0 .019) .The incidence of of ALT increase above Ⅲ degrees was 12 .2% in pemetrexed combination group ,and 35 .0% in paclitaxel combination group(χ2 =7 .238 ,P=0 .007) .The incidence of AST increase rate above Ⅲ degrees was 13 .0% in pemetrexed combi‐nation group and 32 .5% in paclitaxel combination group(χ2 = 4 .706 ,P= 0 .030) .The incidence of neurotoxicity was 28 .2% in pemetrexed combined group ,65 .0% in paclitaxel combined group (χ2 = 11 .652 ,P= 11 .652) .The incidence of gastrointestinal tract reaction above Ⅲ degrees was 47 .8% in pemetrexed combined group ,57 .5% in paclitaxel combined group was ,(χ2 = 0 .803 , P=0 .370) .Cox regression analysis revealed that PS score(HR=0 .207 ,95% CI0 .090-0 .479) and clinical stages(HR=0 .089 , 95% CI0 .041-0 .191) had significant effects on survival of patients .Conclusion Two kinds of treatment in two groups showed the similar curative effects and promised to be first‐line chemotherapy strategy for postoperative patients with NSCLC .However , the pemetrexed combined group showed less drug toxicity compared with that of the paclitaxel combined group .