IP与CAV二线方案治疗复发小细胞肺癌的疗效比较

Clinical efficacy of CPT-11 plus cisplatin and cyclophosphamide doxorubicin and vincristine in treatment of small cell lung cancer

目的比较IP(伊立替康+顺铂)与CAV(环磷酰胺+阿霉素+长春新碱)作为二线方案治疗复发小细胞肺癌(SCLC)的疗效和不良反应。方法复发SCLC患者68例随机分为2组,34例给予IP方案化疗:盐酸依立替康60 mg/m^2静脉滴注,第1、8、15天;顺铂25 mg/m^2静脉滴注,第1～3天,28 d为1周期。另34例给予CAV方案化疗;环磷酰胺800 mg/m^2静脉注射,第1天,阿霉素50 mg/m^2静脉注射,第1天,长春新碱1.4 mg/m^2静脉注射,第1天,21 d为1周期,每例患者至少完成2周期化疗后评价疗效。结果 IP组总有效率41.2%高于CAV组总有效率26.4%(P<0.05)。2组生存时间比较差异无统计学意义(P>0.05)。不良反应主要为血液学毒性及消化道毒性,Ⅳ级毒性比较差异无统计学意义(P>0.05)。结论 IP作为二线方案治疗复发SCLC疗效优于CAV,两者不良反应均可耐受。

Objective To compare the clinical efficacy and adverse reactions of CPT-11 plus cis platin（IP） and cyclophosphamide doxorubicin and vincristine（CAV） in second line treatment of small cell lung cancer（SCLC）.Methods 68 patients with SCLC who had relapsed at least 60 day after completion of first line therapy were randomly divided into IP group （34 patients） and CAV group（34 patients）.Those in IP group were given CPT-11 60 mg/m^2 on the 1st day,8th day and 15th day,coupled with addition of cis platin 25 mg/m^2 from the 1st to 3rd day.A chemotherapeutic cycle of 28 days was repeated at least once in each case;and those in the CAV group were infused cyclophosphamide 800 mg/m^2 coupled with addition of doxorubicin 50 mg/m^2 and vincristine 1.4 mg/m^2 on day 1 every 21 days.All patients after 2 cycles of chemotherapy were collected two sets of clinical data and clinical assessment of efficacy and toxicity.Results The response rate of IP group was 41.2%,and that of CAV group was 26.4%,with significant difference（P 0.05 ）.In the adverse effects of treatment, the main toxicity included the bone marrow suppression and gastrointestinal disturbance（P 0.05）.Conclusion IP regimen has the prior effect than CAV regimen in second line treatment of SCLC owing to its better efficacy and equal toxicity,so IP regimen is firstly recommended in the chemotherapy for recurrent SCLC.