小剂量EP方案治疗小细胞肺癌肝转移合并严重肝功能异常患者的疗效观察

Efficacy observation of low-dose EP regimen in the treatment of small cell lung cancer patients with hepatic metastasis and severe liver dysfunction

目的：探讨小剂量EP方案（依托泊苷＋顺铂）治疗小细胞肺癌肝转移合并严重肝功能异常患者的肝功能改善情况。方法：收集2007—2012年我院肿瘤科收治的小细胞肺癌肝转移初治患者，且治疗前血清生化检查天门冬氨酸氨基转移酶（AST）≥正常值上限5倍及／或丙氨酸氨基转移酶（ALT）≥正常值上限5倍。总胆红素（TBIL）≥正常值上限3倍。应用依托泊苷100mg静脉滴注，d1～5；顺铂20mg，d1～5，21d为1周期，进行化疗2周期后，再次检测患者的肝功能指标。结果：共有8名患者纳入本研究，经过化疗后，所有患者肝功能指标均下降。结论：在无其他肝脏疾病的前提下，小剂量EP方案对于小细胞肺癌肝转移合并肝功能严重异常的患者较为安全，对改善患者肝脏功能有一定效果，临床疗效有待进一步探索。

Objective： To observe the improvement of liver function by using low-dose EP regimen （etoposide and cisplatin） in small cell lung cancer patients with hepatic metastasis and severe liver dysfunction. Methods： From 2007 to 2012, chemotherapy-naive patients who had small cell lung cancer with severe liver dysfunction （aspartate aminotransferase and/or alanine aminotransferase ≥ 5 × ULN, total bilirubin ≥3 × ULN before chemotherapy） secondary to hepatic metastasis were recruited, and treated with low-dose EP regimen which was intravenous infusion of etoposide 100 mg and cisplatin 20 mg from day 1 to 5 with every 3 weeks as a cycle. Liver function indexes were tested after two cycles of chemotherapy. Results： All those patients＇ liver function improved after chemotherapy. Conclusion： After the exclusion of other liver diseases, low-dose EP regimen was relatively safe in the small cell lung cancer patients with hepatic metastasis and severe liver dysfunction, and could improve the patients＇ liver function. The further study should be warranted to confirm the clinical effect.