目的 探讨培美曲塞联合顺铂治疗宫颈癌的临床疗效和安全性。方法 选择2010年2月-2014年2月辽宁省肿瘤医院收治的宫颈癌患者100例,随机分为对照组和治疗组,每组50例。对照组患者在每个化疗疗程的第一天使用注射用顺铂50 mg/m²加入250 mL生理盐水中静脉滴注,时间大于2 h。治疗组患者在第一天使用注射用培美曲塞二钠500 mg/m²加入250 mL生理盐水中静脉滴注,时间大于10 min。培美曲塞滴注结束后30 min开始滴注注射用顺铂,用法用量同对照组。两组均以21 d为1个化疗疗程,至少进行4个疗程的化疗。评价两组患者的临床疗效和毒副反应。结果 治疗后,对照组总有效率为24.0%,临床获益率为52.0%;治疗组总有效率为44.0%,临床获益率为74.0%,两组患者总有效率、临床获益率比较差异有统计学意义(P<0.05)。治疗过程中,两组患者均可发生白细胞减少、红细胞减少、中性粒细胞减少、恶心、呕吐、腹泻、发热、口腔黏膜炎等不良反应,且治疗组的发生率显著低于对照组,两组比较差异有统计学意义(P<0.05)。治疗组的无进展生存期(PFS)和总生存时间(OS)分别平均为5.2个月和10.3个月,对照组分别为3.8个月和9.7个月,两组比较差异有统计学意义(P<0.05)。结论 培美曲塞联合顺铂治疗宫颈癌具有较好的临床疗效,可降低化疗的不良反应,值得临床推广应用。

Objective To investigate the efficacy and safety of pemetrexed combined with cisplatin in treatment of cervical cancer. Methods Patients (100 cases) with cervical cancer who came to Liaoning Cancer Hospital from February 2010 to February 2014 were randomly divided into the control and treatment groups, and each group had 50 cases. The patients in the control group were iv administered with Cisplatin for injection (50 mg/m² diluted with 250 mL physiological saline) more than 2 h on the first day. The patients in the treatment group were iv administered with Pemetrexed Disodium for injection (500 mg/m² diluted with 250 mL physiological saline) more than 10 min. And they were given Cisplatin for injection when pemetrexed dripped 30 min later, while the usage and dosage of Cisplatin for injection were same with control group. One course of treatment was 21 D, and two groups were treated for at least four courses of chemotherapy. The clinical curative effect and adverse reaction in two groups were evaluated. Results After treatment, the total effective rate of control group was 24.0%, and the clinical benefit rate was 52.0%, while the total effective rate of treatment group was 44.0%, and the clinical benefit rate was 74.0%, and there were differences between two groups (P< 0.05). Adverse reactions such as reducing of white blood cells, red blood cells, and neutropenia, nausea, vomiting, diarrhea, fever, inflammation of oral mucosa can happen in two groups during the course of the treatment, and the incidence rate of treatment group was significantly lower than that of the control group, and there were differences between two groups (P< 0.05). The progression-free survival (PFS) and overall survival (OS) in treatment group were 5.2 months and 10.3 months, respectively, while those in the control group were 3.8 months and 9.7 months, and there were differences between two groups (P< 0.05). Conclusion Pemetrexed combined with cisplatin has the good clinical effect in treatment of cervical cancer, and can reduce the adverse reaction of chemotherapy, which is worth clinical promotion.