羟基喜树碱联合化疗治疗恶性肿瘤的多中心临床研究

A multi-center clinical study on combined chemotherapy of hydroxycamptothecine

目的 探讨羟基喜树碱为主的联合化疗方案治疗中晚期肺癌、食管癌和消化道肿瘤的临床疗效和毒副反应。方法 小细胞肺癌应用HEP方案 :HCPT 8mg m2 静脉滴注 ,DDP 15mg m2 静脉滴注 ,VP 16 70mg m2 静脉滴注 ,连用 5d。非肺小细胞癌应用HAP :HCPT、DDP同前 ,ADM THP 2 0mg m2 静脉推注 ,1、2d(或 6、7d)。食管癌应用HLFP方案 :HCPT、DDP同前 ,LV 10 0mg ,5 Fu 5 0 0mg m2 静脉滴注 ,连用 5d。消化道癌应用HMLF方案 :HCPT、LV、5 Fu同前 ,MTX 6 0mg m2 静脉推注 1d。以上方案每 4周重复为 1周期 ,2周期为 1疗程。结果 近期疗效 :180例中 ,CR者 14例 (7.8% ) ,PR者 87例 (48..3% ) ,SD者 6 6例 (36 .7% ) ,有效率 (CR +PR) 5 6 .1% ,化疗受益率 (CR +PR +SD) 93 .9%。其中 ,初治 12 6例 ,CR11例 ,PR 6 4例 ,有效率 5 9.5 % ;复治 5 4例 ,CR 3例 ,PR 2 3例 ,有效率 48.1%。小细胞肺癌局限期 14例 ,CR 5例 ,PR 7例 ,有效率 85 .7% ;广泛期 9例 ,CR 1例 ,PR 5例 ,有效率 6 6 .7%。非小细胞肺癌 79例 ,CR4例 ,PR 39例 ,有效率 5 4.4%。食管癌 2 9例 ,CR 2例 ,PR 12例 ,有效率 48.3 %。消化道癌 49例 ,CR 1例 ,PR 2 4例 ,有效率 5 1%。毒副反应主要为骨髓抑制、消化道反应如恶心、呕吐、腹泻 。

Objective To evaluate the efficacy and toxicity of combined chemotherapy containing Hydroxycamptothecine in the treatment of advanced lung cancer,esophagus cancer and alimentary track cancer.Methods SCLC patients were treated with HEP regimen, HCPT 8 mg/m 2,DDP 15 mg/m 2,VP 16 70 mg/m 2,IV infusion d 1～5.NSCLC patients were treated with HAP regimen, HCPT 8 mg/m 2,DDP 15 mg/m 2,IV infusion d 1～5 and ADM/THP 20 mg/m 2 IV d1,2 or d 6,7.Esophagus cancer patients were treated with HLFP regimen, HCPT 8 mg/m 2,DDP 15 mg/m 2,LV 75 mg/m 2,5 Fu 500 mg/m 2,IV infusion d 1～5.Alimentary track cancer patients were treated with HMLF regimen, HCPT 8 mg/m 2,LV 100 mg,5 Fu 500 mg/m 2,IV infusion d 1～5,MTX 60 mg/m 2 d 1.The regimens were repeated every 4 weeks as 1 cycle. One course consisted of two cycles.Results Of 180 cases were evaluated for efficacy, 14 achieved CR (7.8%)and 87 PR(48.3%)and 66 SD(36.7%).Over all response rate (CR+PR) was 56.1%,benefit (CR+PR+SD)rate was 93.9%. The main side effects were mild and tolerated myelosuppression and nausea, vomiting and diarrhea.Conclusion Combined chemotherapy with HCPT containing regimen showed wide antitumor spectrum, higher efficacy and lower toxicity. It can become a routing regimen in the treatment of several malignancies.