Clinical comparison study on pemetrexed combined with carboplatin versus paclitaxel combined with carboplatin as concurrent chemoradiotherapy in locally advanced non-small cell lung cancer

Objective To observe the effect and clinical toxicity of pemetrexed combined with carboplatin versus paclitaxel combined with carboplatin with concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).Methods Total of 60 patients stage Ⅲ NSCLC (ⅢA 39 patients,ⅢB 21 patients) were randomly assigned into two groups.Pemetrexed combined with carboplatin group:accepted pemetrexed 500 mg/m2,d1,carboplatin AUC 5,d1,once every 21 days.Paclitaxel combined with carboplatin group:paclitaxel 150 mg/m2,d1,carboplatin AUC 5,d1,once every 21 days.Two groups both accepted 3-D conformal radiation therapy (3D-CRT) during chemotherapy.The total dose was 60 ～ 70 Gy.After radiation therapy,the patients were accepted 2 ～ 3 cycles of chemotherapy.Results The efficacy of pemetrexed combined with carboplatin and paclitaxel combined with carboplatin were 44.83％ and 29.03％ respectively.The disease control rates of two groups were 79.31％ and 67.74％ respectively.The differences were statistically significant (P＜0.05).The adverse reactions of pemetrexed group were rare.Two groups of median progression-free survival were 12.5 and 9.9 months respectively.1 year overall survival was 58.62％ and 48.39％ respectively.The differences were also significant (P＜0.05).Conclusion Pemetrexed combined with carboplatin can be used as stage Ⅲ NSCLC patients treated with concurrent chemoradiation regimens during optimization.Toxicity was tolerable.Pemetrexed group was better than paclitaxel group in disease control rates and survival. Key words: Pemetrexed;  Paclitaxel;  Concurrent chemoradiotherapy;  Non-small cell lung cancer