自体外周血干细胞支持高剂量化疗治疗小细胞肺癌的研究

STUDY OF HIGH-DOSE CHEMOTHERAPY COMBINE AUTOLOGOUS PERIPHERAL BLOOD STEM CELL SUPPORT ON TREATMENT OF SCLC

目的 比较自体外周血干细胞支持下高剂量化疗与常规剂量化疗治疗小细胞肺癌的疗效、中位生存期、累计生存率的差异 ,并评价与高剂量化疗有关的毒性。方法 小细胞肺癌 39例中 19例为自体外周血干细胞支持下高剂量化疗 ,2 0例为常规剂量化疗。化疗方案以 IVP、CVp P为主 ,高剂量为常规剂量的 3倍 ,造血因子 G- CSF动员干细胞 ,高剂量化疗及常规化疗组 2疗程后 ,除 b、 期外均给予手术或放疗。结果 高剂量化疗后缓解率为 10 0 % ,中位生存期11个月 ,常规剂量缓解率为 85 % ,中位生存期 8个月 ,累计生存率经时序检查 (log rank test) (P<0 .0 5 )。高剂量化疗的主要毒性反应为 °白细胞、血小板下降 ,在干细胞回输第 11天和第 15天恢复正常。结论 自体外周血干细胞支持下高剂量化疗的缓解率和累计生存期优于常规化疗 ,引起的骨髓功能抑制亦能在短期内恢复。

Objective To compare the response to treatment, medium survival time, and cumulative survival rate of high dose chemotherapy under support of autologous peripheral blood stem-cells with these of conventional chemotherapy (CDCT) in the treatment of SCLC the treatment-related toxicity of high dose chemotherapy(HDCT)was evaluated.Methods 39 patients of age ≤65 yrs SCLC entered this study. 19 patients were given high dose of CTX (3.0 g/m 2),Vp16(750 mg/m 2), Carbaplatin (400 mg/m 2) and cisplatin (60 mg/m 2) with autologous peripheral blood stem cell support after 1-3 cycles of conventional chemotherapy. 20 patients were given 2 cycles of conventional chemotherapy of IVP,CVpP,IVpP.Results The response rate to conventional-dose was 85 %, to high-dose chemotherapy was 100% ( P >0 05). The medium survival times of these two groups were 11 months and 8 months respectively, The cumulative survival rate of HDCT was statistical better then CDCT( P <0 05).The severe toxicity of HDCT was Ⅳ° granulocytopenia and thrombocytopenia.Conclusion High dose chemotherapy with support of autologous peripheral blood stem cells is a more effective therapy for SCLC as compared with conventional dose chemotherapy, as the response rate is increased and the cumulative survival rate is significantly improved.