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目的：探讨培美曲塞联合顺铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效。方法：随机选取我院肿瘤科晚期NSCLC 患者 177 例，随机将其分为3 组，培美曲塞联合顺铂治疗（PP 组）72 例，多西他赛联合顺铂治疗（DP 组）53 例，吉西他滨联合顺铂治疗（GP组）52例，比较三组治疗方法的临床疗效与不良反应之间的差异，根据临床疗效将PP组分为有效组与无效组，分析培美曲塞联合顺铂治疗晚期NSCLC的影响因素。结果：PP组疾病控制率（DCR）与客观有效率（ORR）均显著高于GP 组（均P＜0.05）；PP 组与DP 组近期疗效之间的比较无显著差异（均P＞0.05）。PP组的药物毒副作用均显著优于DP组与GP组（均P＜0.05）。PP 组的中位生存期显著高于DP 组与GP 组（均P＜0.05），在无吸烟、腺癌与IV 期晚期NSCLC 患者中，培美曲塞联合顺铂治疗有效率更高。结论：培美曲塞治疗晚期NSCLC 的疗效佳，与多西他赛相当并显著优于吉西他滨治疗，药物毒副作用小，且受吸烟状况、病理类型与临床分期影响。

英文摘要:

Objective:To study clinical curative effect of advanced non-small cell lung cancer (NSCLC) treated by Pemetrexed combined cisplatin.Methods:177 cases of advanced NSCLC patients were selected from our hospital and divided into 3 groups randomly, PP group (n= 72)gave treatment of pemetrexed combined cisplatin , DP group (n= 53) gave treatment of docetaxel combined cisplatin, GP group (n= 52) gave treatment of gemcitabine combined cisplatin, clinical curative effect and adverse reaction were compared. According to clinical efficacy , PP group was divided into effective group and ineffective group, analyzed factors for the treatment of pemetrexed combined cisplatin to advanced NSCLC.Results:DCR and ORR of PP group were significantly higher than that of GP group (all P < 0.05); The comparison between PP group and DP group in the near future curative effect had no significant difference (P > 0.05). The drug side effect of PP group were significantly superior to DP group and GP group (all P < 0.05). Median surial in PP group is significantly higher than DP group and GP group (all P < 0.05), pemetrexed combined cisplatin treatment efficiency is higher in the absence of smoking, IV stage and adenocarcinoma in patients with advanced NSCLC.Conclusion:The curative effect in the treatment of pemetrexed to advanced NSCLC, nearly docetaxel and significantly better than gemcitabine, less drug side effect and affected by the smoking status, pathological type and clinical stage.

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