拓扑替康联合卡铂与足叶乙苷联合卡铂比较一线治疗小细胞肺癌临床研究

A clinical study comparing topotecan plus carboplatin versus etoposide plus carboplatin for previously untreated small cell lung cancer

目的比较拓扑替康联合卡铂（TC）与足叶乙苷联合卡铂（CE）一线治疗小细胞肺癌的疗效及不良反应。方法初治小细胞肺癌患者69例，TC组（34例）：应用拓扑替康1mg／m2，静脉滴注，第1—5天，卡铂300mg／m2，静脉滴注，第1天。CE组（35例）：应用足叶乙苷100mg／d，静脉滴注，第1—5天，卡铂300mg／m2，静脉滴注，第1天。两种方案均以21d为1个周期。2个周期后评价疗效及不良反应。结果TC组有效率为76．5％，CE组有效率为71．4％，两组比较差异无统计学意义，P〉0．05；TC组无进展生存期为4．1个月，CE组无进展生存期为2．6个月，两组比较差异有统计学意义，P〈0．05；两组不良反应发生率比较差异均无统计学意义，P〉0．05。结论与足叶乙苷联合卡铂方案相比，拓扑替康联合卡铂方案疗效相似，不良反应相近，且无进展生存期延长，是小细胞肺癌一线治疗的安全有效方案。

Objective To assess the efficacy and toxicity of topotecan hydrochloride plus carboplatin （TC）versus etoposide plus carboplatin （CE）in patients for previously untreated small cell lung cancer （SCLC）. Methods Sixty-nine patients with previously untreated SCLC, TC group （34 cases）were treated with topotecan 1 mg/m2 from day 1 to day 5 and carboplatin 300 mg/ m2 on day 1. CE group （35 cases） were treated with etoposide 100 mg/d from day 1 to day 5 and carboplatin 300mg/m2 on day 1. Treatment was repeated every 3 weeks. The efficacy and toxicity were evaluated in patients who received two cycles of chemotherapy. Results The total effective rate was 76.5% in TC group and 71.4% in CE group （P 〉 0.05 ）. The progression-free survival interval was 4.1 months in TC group and ：2.6 months in CE group （P 〈 0.05 ）. There was no significant difference in the most common toxicities between two groups（P 〉 0.05 ）. Conclusion Compared with etoposide plus carboplatin, topotecan plus carboplatin has similar total effective rate, and indifferent toxicities, and the longer progression-flee survival interval, so it is a safe and effective first -line treatment for SCLC.