两种方案治疗广泛期小细胞肺癌的临床观察

Clinical Analysis of Two Chemotherapy Regimens for Patients with Extensive Small-cell Lung Cancer

目的:比较两种不同化疗方案治疗广泛期小细胞肺癌的临床疗效及毒副反应。方法:回顾性分析2010年1月至2013年1月,我院肿瘤科住院治疗的70例广泛期小细胞肺癌患者的临床资料,分为伊立替康(IP)组和VP-16(EP)组,每组各35例患者,其中伊立替康组患者采用伊立替康联合顺铂方案化疗,VP-16组患者采用VP-16联合顺铂方案化疗,观察两组方案治疗患者的近期临床效果和毒副反应情况。结果:伊立替康(IP)组和VP-16(EP)组患者的有效率分别为74.28%(26/35)和71.42%(25/35),两组比较差异无统计学意义(P>0.05);无进展生存期分别是4.3个月和3.7个月(P>0.05),总生存期分别是9.3个月和8.9个月(P>0.05)。伊立替康(IP)组的主要不良反应是粒细胞减少、血小板减少、贫血、腹泻、消化道反应,发生率分别为54.29%、14.29%、25.71%、22.86%、71.43%,VP-16(EP)组的主要不良反应反应为粒细胞减少、血小板减少、贫血、腹泻、消化道反应,发生率分别是80.0%、60.0%、54.29%、2.86%、74.29%。结论:IP和EP方案一线治疗广泛期小细胞肺癌的疗效和生存期无显著差异,不良反应均可耐受。

Objective： To compare and analyze the efficacy and safety of two different treatment schema in previ-ously untreated extensive small-cell lung cancer. Methods：Seventy cases of patients with extensive small-cell lung cancer treated in the Oncology Department of our hospital from January 2010 to January 2013 were randomly assigned into irinote-can group（ IP group,35 cases） and VP-16 group（ EP group,35 cases） by random number table . Patients in IP group were treated with irinotecan and cisplatin（IP）and in EP group were treated with VP-16 and cisplatin（EP）. The treatment re-sponse was assessed by the Response Evaluation Criteria in Solid Tumors （RECIST） （version 1. 1）. Patients were assessed for toxicity according to WHO criteria for adverse events. Results：The objective response rates（ RR） of IP group and EP group were 74. 28% and 71. 42%,respectively（P〉0. 05）. The median progression-free survival（PFS） for IP group and EP group were 4. 3 and 3. 7 months respectively（P〉0. 05）. The overall survival（OS） for IP group and EP group was 9. 3 and 8. 9 months,respectively（P〉0. 05）. The common adverse effects of IP group inclucled neutropenia（54. 29%）,throm-bocytopenia（14. 29%）,anemia（25. 71%）,diarrhea（22. 86%）and nausea（71. 43%）. The common adverse effects of EP group included neutropenia（80. 0%）,thrombocytopenia（60. 0%）,anemia（54. 29%）,diarrhea（2. 86%）and nausea（74. 29%） . Conclusion：The study shows that there is no significant difference with the efficacy and survival of IP and EP regi-men as the first-line therapy for extensive small-cell lung cancer and the adverse effects are tolerant.