洛铂联合依托泊苷治疗小细胞肺癌的临床疗效

Comparison between etoposide plus cisplatin and etoposide plus lobaplatin in the treatment of small-cell lung cancer

目的评价洛铂联合依托泊苷治疗初治小细胞肺癌的疗效和毒副反应,并与同期应用的顺铂联合依托泊苷治疗初治小细胞肺癌的方案相比较。方法分析呼吸内科住院治疗的45例初治小细胞肺癌患者,其中洛铂治疗组25例:洛铂50mg/m2,iv,d1,依托泊苷:100 mg/m2,iv,d 1～3;顺铂治疗组20例:顺铂80 mg/m2,iv,d1,依托泊苷:100 mg/m2,iv,d1～3;并对两组患者近期疗效及毒副反应进行比较。结果洛铂组CR 8例,PR 9例,SD 4例,PD 4例;顺铂组CR 9例,PR 7例,SD 3例,PD 2例;两组总有效率为68%和80%,差异无统计学意义(P=0.805)。全组主要毒性反应为骨髓抑制。顺铂组Ⅲ-Ⅳ度胃肠道反应及脱发明显高于洛铂组,差异有统计学意义(P<0.05)。结论洛铂联合依托泊苷治疗初治小细胞肺癌疗效确切,毒副反应小,与顺铂联合依托泊苷方案相比,疗效相似。

Objective To compare the efficacy and adverse effects between the regimen of etoposide and cisplatin and the regi- men of etoposide and lobaplatin in the treatment of small-cell lung cancer. Methods 42 patients with small-cell lung cancer were ran- domly divided into two groups. The group A （ n = 25 ） was given lobaplatin at 50 mg/m2, i. v on Day 1 and etoposide at 100mg/m2, i. v from Day 1 to Day 3. The group B （n =20） was treated with cisplatin at 80 mg/m2 , i. v on Day 1 and etoposide at 100 mg/m2, i. v from Day 1 to Day 3. Efficacy and adverse effect were compared between the two groups. Results There were 8 cases of CR, 9cases of PR, 4 cases of SD, and 4 cases of PD in the group A, and there were 9 cases of CR, 7 cases of PR, 3 cases of SD, and 2 cases of PD in the group B. The overall response rate was 68% in the group A and 80% in the group B. There was no statistical difference on the re- sponse rate between the two groups （P =0. 805 ）. The main adverse reaction included bone-marrow depression. The incidence of Ill-iV nausea/vomiting and alopecia was higher in the group A than in the group B （ P 〈 0. 05 ）. Conclusion The etoposide plus lobaplatin reg- imen is an effective and low-toxicity chemotherapy in initial treatment of small-cell lung cancer, which has the similar curative effect with the regimen of etoposide and cisplatin.