Pemetrexed plus cisplatin versus gemcitabine plus cisplatin for advanced non-small-cell lung cancer

Objective: To compare the short-term curative effect,side effects and survival of pemetrexed（PEM） plus cisplatin and gemcitabine（GEM） plus cisplatin for advanced non-small-cell lung cancer（NSCLC）. Methods: Thirty patients with stage ⅢB or Ⅳ NSCLC confirmed by pathology or cytology were randomly assigned to PEM group or GEM group.Patients in PEM group received intravenous infusion of pemetrexed（500mg/m²） and cisplatin（75mg/m²） with hydration on day 1 after admission.Patients in GEM group were given gemcitabine（1 000mg/m²） and cisplatin（75mg/m²） with hydration on day 1 after admission.Treatment was repeated every 21 days.Response and toxicity were evaluated in patients who received two cycles of chemotherapy. Results: The response rate was 25.0% in PEM group and 21.4% in GEM group.The disease control rate was 81.3% in PEM group and 71.4% in GEM group.The time to progression was 6.3 months in PEM group and 5.8 months in GEM group.The survival time was 11.9 months in PEM group and 10.1 months in GEM group.There was no significant difference between the two groups（P＞0.05）.The incidence rate of myelosuppression and non-hematology toxicity was lower in PEM group than in GEM group. Conclusion: Patients have a similar response rate to pemetrexed plus cisplatin and gemcitabine plus cisplatin and a lower toxicity than gemcitabine plus cisplatin.Pemetrexed plus cisplatin can be used in treatment of NSCLC.