TEP方案治疗小细胞肺癌21例临床分析

Clinical observation of TEP regimen in the treatment of small-cell lung cancer

探讨拓扑替康 (topotecan ,TPT)联合依托泊苷 (etoposide ,Vp 16)、顺铂 (cisplatin ,DDP)组成的TEP方案治疗小细胞肺癌 (small celllungcancer ,SCLC)的临床疗效。 2 1例初治SCLC患者接受治疗 ,Vp 1670mg/ (m2 ·d) ,连用 5d ;TPT0 7mg/ (m2 ·d) ,于Vp 16后 1h应用 ,静脉滴入 3 0min ,连用 5d ;DDP 80mg/m2 ,分 3d静脉滴入。 2 1d为 1个周期 ,至少化疗 2个周期。 2 1例患者均可评价疗效。其中CR 8例 ,PR 8例 ,有效率 (RR)为 76 2 % ( 16/ 2 1) ,局限期 (LD)RR为90 0 % ( 9/ 10 ) ,广泛期 (ED)RR为 63 6% ( 7/ 11) ,其中 4例脑转移者PR 1例 ,SD 1例 ;全组患者中位生存期 11 5个月 ,1、2年生存率分别为 42 9% ( 9/ 2 1)和 19 0 % ( 4 / 2 1) ;2 1例患者均可评价不良反应 ,主要不良反应为骨髓抑制 ,Ⅲ～Ⅳ度白细胞减少的发生率 76 2 % ( 16/ 2 1) ,血小板减少的发生率为 61 9% ( 13 / 2 1) ,非血液学毒性主要为恶心、呕吐、脱发、乏力、肝肾功能异常等。TEP方案疗效肯定 ,能改善SCLC的生存期及生存率 ,可作为SCLC的一线治疗方案 ;主要不良反应为骨髓抑制 。

The objective is to evaluate the effects,the survival time and the adverse effects of TEP with (topotecan+etoposide+cisplatin) regimen in the treatment of small-cell lung cancer. A total of 21 patients with previously untreated small-cell lung cancer (SCLC) were included. All patients received etoposide 70 mg/(m 2·d) followed by topotecan 0.7 mg/(m 2·d) an hour later for 5 days, and cisplatin 80 mg/m 2 divided to use for 3 days.All of the patients received 2 cycles of chemotherapy. The overall response rate was 76.2% for TEP regimen with 8 complete response(CR)and 8 partial response (PR). The response rate of limited stage and extensive stage were 90.0% and 63.6% respectively. The median duration of survival was 11.5 months and the 1,2-year survival rates were 42.9% and 19.0%. The main toxicity was myelosuppression for TEP regimen.The incidence rate of Ⅲ-Ⅳ degree neutropenia and thrombocytopenia was 76.2%(16/21) and 61.9%(13/21).In conclusion,the TEP regimen is an effective regimen for treatment of previously untreated SCLC, and the regimen is possibly effective in prevention and treatment of brain metastasis in SCLC patients. The survival duration and survival rate can be improved .The major toxicity is myelosuppression.