依托泊苷联合洛铂或顺铂治疗广泛期小细胞肺癌的对照研究

Comparative study of lobaplatin and cisplatin combined with etoposide for advanced small cell lung cancer

目的观察洛铂(lobaplatin,LBP)或顺铂(cisplatin,DDP)分别联合依托泊苷(etoposide,VP-16)治疗广泛期小细胞肺癌(small cell lung cancer,SCLC)的近期疗效、不良反应和住院情况。方法 46例广泛期SCLC分为DDP联合VP-16的EP组23例,LBP联合VP-16的EL组23例。21d为1周期,连用2个周期评价近期疗效、毒性反应及住院情况。结果 EL组和EP组比较,客观有效率、住院时间、白细胞下降率及血小板下降率,均无显著性差异。两组化疗后肺癌肿瘤标志物中神经元特异性烯醇化酶(NSE)均明显减低,但癌胚抗原(CEA)和细胞角蛋白19片段(CYFRA21-1)无明显减低,两组之间无显著性差异。EL组消化道反应率明显减低,但诊疗费用明显增加。结论 EL和EP同样为广泛期SCLC安全有效的化疗方案,EL组消化道反应明显减少,但医疗费用明显增加。

Objective To observe the short-term therapeutic effect, adverse reaction and hospitalization conditions of lobaplatin plus etoposide （EL） and cisplatin plus etoposide （EP） for advanced small cell lung cancer （SCLC）. Methods A total of 46 patients with advanced SCLC were randomized into EL group （23 patients） and EP group （23 patients）. The two groups were treated for 21 days as one cycle for two cycles. The short-term therapeutic effect, adverse reaction and hospitalization conditions in the two groups were evaluated after two cycles. Results EL group and EP group did not differ significantly in objective response rate, hospital stay, or rate of leukocyte and platelet decrease. In the two groups, NSE reduced significantly after chemotherapy, but CEA and CYFRA21-1 did not. There was no significant difference between the two groups. In EL group, the incidence of gastrointestinal reaction reduced significantly whereas hospitalization cost increased significantly. Conclusion Both EL and EP are a safe and effective chemotherapy for patients with advanced SCLS. Compared with EP chemotherapy, EL chemotherapy brings a significant decrease in gastrointestinal reaction but increase in hospitalization cost.