5天疗程足叶乙甙治疗老年小细胞肺癌对比观察

A Comparative Study of 5-day Etoposide Regimen for Small Cell Lung Cancer in Elderly Patients

[目的]对比观察足叶乙甙(Etoposide)静脉5天用药治疗老年小细胞肺癌的疗效和毒性.[方法]60例老年患者经病理证实为小细胞肺癌,采用单药足叶乙甙和EP+EPI(EPE)两组方案化疗.单药组足叶乙甙0.1,静滴,第1～5天;EPE方案组:足叶乙甙0.1,静滴,第1～3天,顺铂30～40mg,静滴,第1～3天,表阿霉素40～60mg,静注,第1天.两组均以21～28天为1个周期.[结果]单药组和EPE组有效率(CR+PR)分别是83%和93%(P＞0.05),两组1、2、3年生存率分别为67%、40%、20%和70%、37%、13%.单药组毒性反应较轻,患者均能耐受,以Ⅰ～Ⅱ度轻度骨髓抑制为主.而EP+EPI组表现有明显的骨髓抑制和消化道反应.[结论]单独静脉5天用药足叶乙甙治疗老年小细胞肺癌的疗效可靠、耐受好、有效率高.

To evaluate the efficacy and toxicity of 5-day schedule of etoposide in elder patients with small cell lung cancer (SCLC). Sixty cases with histology or cytology proven SCLC patients were randomized into two groups. Single-agent group patient received etoposide 0.1 by infusion, on day 1~5. EP+EPI(EPE) group: etoposide 0.1 by infusion, on day 1~3; DDP 30~40mg by infusion, on day 1~3; EPI 50~70mg, iv on day 1. The regimen was repeated every 3~4 weeks. All patients could be assessed for response, toxicity and survival. The overall response rate (OR) were 83% in single-agent group and 93% in EPE group(P>0.05). 1-, 2- and 3-year survival rates were 67%, 40%, 20% in single-agent group and 70%, 37%, 13% in EPE group, respectively. Toxicity was well tolerated, and myelosuppression was the main toxicity with grade 1~2 in the majority in EPE group. Obvious myelosuppression and digestive toxicity were shown in EPE group. [Conclusion] The 5-day schedule of etoposide administration in elder patients with small cell lung cancer was effective and tolerable, with encouraging response.