诺维本加异环磷酰胺治疗复发性小细胞肺癌36例临床报告

Clinical observation of navelbine plus ifosfamide in the second-line treatment for 36 cases of recurrent small cell lung cancer

目的探讨诺维本（NVB）与异环磷酰胺（IFO）联合作为二线方案治疗复发小细胞肺癌（SCLC）的疗效及毒副作用。方法采用NVB加IFO（NI）方案治疗复发SCLC患者36例。化疗剂量：NVB25mg／m^2 d1、8；IFO1．2～1．5g／m^2d2～4，配合mesna解毒，同时水化。每3周重复，至少治疗2周期。结果共完成92周期，中位数2周期。无CR病例，PR12例，SD17例，PD7例，总有效率33．33％。主要毒副作用是骨髓抑制、恶心呕吐及静脉炎。白细胞减少为55．55％（20／36），其中Ⅲ＋Ⅳ度为5．55％（2／36）；恶心呕吐及静脉炎发生率分别为75．00％（27／36）及38．89％（14／36），均为Ⅰ、Ⅱ度。结论NI方案治疗复发小细胞肺癌疗效较好，毒副作用可耐受，有较好的临床应用价值。

Objective To evaluate the efficacy and toxicity of combined chemotherapy with navelbine （NVB） plus ifosfamide （IFO） in the second-line treatment of recurrent small cell lung cancer （SCLC）. Methods Thirty - six patients with recurrent SCLC were enrolled for this study. Navelbine were administered 25mg/m^2 on day 1、8, ifosfamide 1.2 - 1.5g/m^2 on day 1-4 which was recycled every 3 weeks and with at least 2 cycles. Results 92 cycles of the chemotherapy were completed and median cycles of the treatment were 2. Among them, 12 patients achieved partial response, 17 patients achieved stable diseases and 7 patients achieved progressive diseases. The overall response rate is 33.33% （12/36）. The main toxicities were myelosuppression, nausea/vomiting and phlebitis. Leukopenia accounted for 55.55 % grade Ⅲ＋Ⅳ was 5.55 %, nausea/vomiting accounted for 75.00% and phlebitis accounted for 38.89%, which were all grade Ⅰ and Ⅱ Conclusion The schedule of navelbine and ifosfamide in the second - line treatment of recurrent SCLC has good chinical efficancy and tolerability, the regimen could be quite clinically valuable.