洛铂或顺铂联合依托泊苷治疗初治小细胞肺癌临床疗效的观察

A Clinical Study on the Short-term Efficacy of Lobaplatin or Cisplatin Combined with Etoposide in Initial Treatment of Small Cell Lung Cancer

目的评价洛铂联合依托泊苷化疗方案(EL方案)治疗初治小细胞肺癌(SCLC)的近期疗效和不良反应,并与顺铂联合依托泊苷化疗方案(EP方案)对比。方法选择2011年6月至2012年1月我科收治的51例初治小细胞肺癌患者为研究对象,所有患者均经病理组织学或细胞学确诊,洛铂组采用EL方案,即洛铂30mg·m-2静滴,d1;依托泊苷100mg·m-2静滴,d1～3;3周为1周期。顺铂组采用EP方案,即顺铂25mg·m-2静滴,d1～3;依托泊苷剂量及用法同洛铂组,21d为1周期,连续用药2周期以上。参照RECIST1.1和CTCAE-3标准评价近期疗效和不良反应。结果洛铂组1例(4.5%)完全缓解,11例(50.0%)部分缓解,治疗总有效率为54.5%,顺铂组1例(3.4%)完全缓解,19例(65.5%)部分缓解,治疗总有效率为68.9%,两组间差异无统计学意义(P=0.291)。洛铂组Ⅲ～Ⅳ度血小板降低发生率(2例,9.1%)高于顺铂组(1例,3.4%),但差异无统计学意义(P=0.396)。洛铂组Ⅲ～Ⅳ度胃肠道反应(1例,4.5%)明显低于顺铂组(8例,27.6%),差异有统计学意义(P=0.033)。结论 EL方案与EP方案治疗初治小细胞肺癌的疗效相似,血小板降低作用增加,但胃肠道反应较轻,安全耐受性好。

Objective To observe the short-term effectiveness and adverse reaction of the chemotherapeutic regimen EL in which lobaplatin combined with etoposide in the initial treatment of small cell lung cancer, and make the comparison with EP regimen in which cisplatin with etoposide. Methods In this study, 51 small cell lung cancer patients all confirmed histopathologically or cytologically in our hospital from June 2011 to January 2012 were enrolled. Lobaplatin group： LBP 30 mg.m-2 iv, day 1; VP-16 100 mg.m-2 iv, days 1-3; every 21 days was a cycle. Cisphtin group： PDD 25 mg.m-2iv, day 1-3; the dose and usage of VP-16 was as same as lobaplatm＇s group; every 21 days was a cycle. The short term effects were evaluated referring to RECISTI.I.The adverse reactions were graded using NCI-CTC-3. Results In lobaplatin group, there was one case of complete remission （CR, 4.5%） and 11 cases of partial remission （PR, 50.0%）, and the total effective rate was 54.5 %. In cisplatin group, there was one case of complete response （C1L, 3.4%） and 19 cases of partial remission （PR., 65.5 %）, and the total effective rate was 68.9 %. There was no statistical difference between the two groups （P = 0.291）. The incidence of Ⅲ-Ⅳ thrombocytopenia in lobaplatin group （2 cases, 9.1%） was higher than that of cisplatin group （1 case, 3.4%）, but with no statistical difference （P = 0.369）. Conversely, the incidence of Ⅲ-Ⅳ nausea/vomiting in lobaplatin group （1 case, 4.5 %） was conspicuously lower than that of cisplatin group （8 cases, 27.6%） （P= 0.033）. Conclusion The effectiveness of the regimen of lobaplatin with etoposide is similar to that ofcisplatin with etoposide in the initial treatment of small cell lung cancer. The regimen oflobaplatin with etoposide also strengthened thrombocytopenia but caused less gastrointestinal reaction. It is well tolerant and has less toxicity.