长春瑞滨、异环磷酰胺联合顺铂治疗复合性小细胞肺癌疗效观察

To observe the effect of combination chemotherapy of Navelbine,Ifosfamide and Cisplatin in the treatment of combined small cell lung cancer

目的观察长春瑞滨(NVB)、异环磷酰胺(IFO)、顺铂(PDD)三药联合治疗复合性小细胞肺癌的临床疗效及不良反应。方法 2008年3月-2010年2月,入组初治Ⅲ～Ⅳ期复合性小细胞肺癌39例,其中小细胞伴鳞癌33例,小细胞伴腺癌1例,复合性小细胞癌未分型5例;Ⅲ期17例,Ⅳ期22例。方案:NVB 25mg/m2静脉滴注,第1、8天;IF01.2mg/m2,静脉滴注,第1～3天,用药后第0、4、8小时给予美司钠解毒;DDP25mg/m2,静脉滴注,第1～3天。21d为1个周期。2周期后评价疗效,疗效及不良反应评定按照WH0标准。结果 37例患者可评价疗效,无完全缓解者,部分缓解15例,稳定18例,进展4例,总有效率为40.5%(15/37),临床受益率为89.2%(33/37)。中位疾病无进展时间为5.5个月,中位生存期为9.2个月,1年生存率为37.9%。主要不良反应为骨髓抑制及胃肠道反应,绝大多数患者耐受良好。结论 NIP方案治疗复合性小细胞肺癌有效且安全。

Objective To observe the effect and adverse reaction of combination chemotherapy of Navelbine （NVB） , Ifosfamide （IFO） and Cisplatin （PDD） in the treatment of combined small cell lung cancer （SCLC） . Methods 39 patients diagnosed as staged Ⅲ to Ⅳ combined small cell lung cancer in our hospital from Mar 2008 to Feb 2010 were enrolled,including 33 SCLC with squamous cell carcinoma,1 with adenocarcinoma and 5 with unclear histological classification. The stages distribution included 17 Ⅲ and 22 Ⅳ. The chemotherapy regimen consisted of NVB 25mg/m2 on days 1 and 8,IFO 1. 2mg/m2 and PDD 25 mg/m2 on days 1 ～ 3 every 21 days. The effect and adverse reaction were evaluated according to standard of WHO. Results In the 37 patients,there were no complete responses,15 partial responses,18 stable diseases,and 4 progressive diseases. Overall response rate was 40. 5% （15/37） ,and the median time to disease progression was 5. 5 months and the median survival was 9. 2 months,one year survival was 37. 9% . The chief adverse reactions were marrow refrain and gastrointestinal effect. Conclusion NIP is active and safe in the treatment of combined SCLC.