伊立替康联合顺铂二线治疗小细胞肺癌的近期疗效及不良反应

Recent curative effect and adverse reaction of irinotecan and cisplatin second line treatment for small cell lung cancer

目的探讨伊立替康联合顺铂二线治疗小细胞肺癌近期临床疗效和不良反应。方法选择一线治疗失败的小细胞肺癌患者30例,采用伊立替康联合顺铂二线治疗,评价其临床疗效及不良反应。结果伊立替康加顺铂联合治疗一线治疗失败的小细胞肺癌30例可评价患者中,CR 3例,占10.0%;PR 11例,占36.7%;SD 10例,占33.3%;PD 6例,占20.0%。总有效率为46.7%,疾病控制率为80.0%。对不同临床分期病例进行分层研究,其中ⅢB期和Ⅳ期小细胞肺癌患者的有效率分别为57.9%和27.3%,ⅢB期患者的有效率高于Ⅳ期患者,差异有统计学意义(χ2=5.34,P<0.05)。本组患者的不良反应主要为Ⅰ/Ⅱ度骨髓抑制及呕吐等胃肠道反应,Ⅲ/Ⅳ度不良反应发生率极低,无死亡病例,患者生活质量均有所提高。结论伊立替康联合顺铂二线治疗小细胞肺癌疗效确切,不良反应小。

Objective To study the recent curative effect and adverse reaction of irinotecan and cisplatin sec- ond line treatment for small cell lung cancer. Methods 30 cases of small cell lung cancer patients suffering first line treatment failure were given irinotecan and cisplatin second line treatment, the clinical efficacy and adverse reactions were evaluated. Results There were 3 cases of CR （ 10. 0% ）, 11 cases of PR （36.7%）, 10 cases of SD （33.3 % ） ,6 cases of PD（20. 0% ）. The total effective rate was 46. 7% ,and control rate was 80.0% ;For different clinical stage pa- tients stratified studies, the efficient rates of Ⅲ B period and Ⅳ period were 57.9 % and 27.3 % respectively, Ⅲ B peri- od was higher than Ⅳ period （2（2 = 5.34, P 〈 0.05 ）. The adverse reactions of the patients were mainly Ⅰ / Ⅱ degree bone marrow suppression and gastrointestinal reactions, such as vomiting, the rate of Ⅲ/Ⅳ degree adverse reactions was extremely low without death case, and the patients＇ life quality was improved. Condusinn Irinotecan and cisplatin second line treatment can improve the curative effect of small cell lung cancer with less adverse reactions.