IEP化疗后予EP维持治疗广泛期小细胞肺癌的临床研究

Clinical observation of IEP followed EP chemotherapy in treatment of extensive-stage small cell lung cancer

背景与目的:广泛期小细胞肺癌生存率较差,目前尚无明确的化疗方案效果能优于传统的EP(依托泊甙及顺铂)方案,所以有必要对已有的化疗药物进行优化组合。本研究初步探讨采用IEP方案初治后予EP方案维持化疗与EP方案起始化疗对广泛期小细胞肺癌的生存改善。方法:选择2004年1月25日—2007年9月5日期间来我科就诊的广泛期小细胞肺癌患者68例,按照1∶1随机分为研究组和对照组,研究组34例采取接受IEP3药联合化疗至少2次,后予EP方案维持治疗。对照组直接接受EP2药化疗。以P<0.05作为显著性检验水平。结果:3药化疗组的中位生存时间为15.32个月;2药化疗组患者的中位生存时间为9.30个月,差异无显著性(P=0.0787)。3药化疗组患者的中位疾病进展时间为7.83个月;2药化疗组的中位疾病进展时间为6.92个月,差异有统计学意义(P=0.0164)。提示3药联合联合化疗可延长患者的疾病进展时间,但不能改善总体生存时间。结论:对于广泛期小细胞肺癌患者进行3药化疗可延长疾病进展时间,缓解症状。

Background and purpose：The overall survival time of extensive-stage small cell lung cancer is not satisfactory.No chemotherapy schemes more effective than etoposide combined with cisplatin,and other optimum combinations should be under evaluation.The aim of this study was to investigate the survival advantage of IEP followed by EP chemotherapy in the treatment of extensive-stage small cell lung cancer compared with EP chemotherapy alone.Methods：From Jan 2004 to Sep 2007,68 extensive-stage small cell lung cancer patients were enrolled in this project and were randomly divided into research group and control group in the ratio of 1：1.In the research group,34 patients accepted IEP chemotherapy at least two times followed by EP chemotherapy maintenance therapy.34 patients as control group accepted EP chemotherapy only.Statistical signifi cance was defi ned as P0.05.Results：The median overall survival time of the research group was 15.32 months and the control group was 9.30 months.There were no signifi cant differences between the two groups（P=0.0787）.The median time to progression of the research group was 7.83 months and 6.92 months for the control group,respectively.There were no signifi cant differences between the two groups（P=0.0164）.It is suggested that IEP followed by EP chemotherapy in treatment of extensive-stage small cell lung cancer could get a better progression free survival,but the overall survival time has not been improved.Conclusion：We conclude that those patients with extensive-stage small cell lung cancer could get better progression free survival by accepting IEP chemotherapy.