不同顺铂给药方案联合依托泊苷治疗广泛期小细胞肺癌的近期疗效及安全性的比较

Comparison of Short-term Clinical Effect of Different Dosing Regimens of Cisplatin Combined with Etoposide on Extensive Small Cell Lung Cancer

目的比较不同顺铂给药方案联合依托泊苷治疗广泛期小细胞肺癌（SCLC）的近期疗效及安全性。方法选择2011年10月—2014年12月在许昌市中心医院呼吸科住院治疗的广泛期SCLC患者95例,随机分为A组34例、B组34例和C组27例。A组患者给予顺铂80 mg/m2,第1天;B组患者给予顺铂40 mg/m2,第1∽3天;C组患者给予顺铂20 mg/m2,第1∽5天。3组患者均联合依托泊苷进行治疗,3周为1个化疗周期。比较3组患者近期疗效、毒副作用及用药依从性。结果因消化道反应不能耐受继续治疗而退出试验者11例,其中A组8例、B组2例、C组1例。3组患者近期疗效比较,差异无统计学意义（u=0.341,P=0.843）。A组患者Ⅲ~Ⅳ度恶心、呕吐发生率高于B组和C组（P〈0.05）。3组患者Ⅱ∽Ⅲ度白细胞计数减少和Ⅰ∽Ⅲ度脱发发生率比较,差异无统计学意义（P〉0.05）。A组患者用药依从率低于B组和C组（P〈0.05）。结论顺铂3 d、5 d连续给药联合依托泊苷治疗广泛期SCLC的近期疗效肯定,较大剂量一次给药消化道反应轻,患者用药依从性良好。

Objective To compare the short-term clinical effect of different dosing regimens of cisplatin combined with etoposide on extensive small cell lung cancer. Methods From October 2011 to December 2014,a total of 94 patients with extensive small cell lung cancer were selected in Xuchang Central Hospital,and they were randomly divided into A group（ n =34）,B group（ n = 34） and C group（ n = 27）. Patients of A group received cisplatin at the dosage of 80 mg / m2 on the first day; patients of B group received cisplatin at the dosage of 40 mg / m2 on the first day to the third day; patients of C group received cisplatin at the dosage of 20 mg / m2 on the first day to the fifth day. All of the three groups received etoposide at the same time,and treated for 3 weeks as a course. Short-term clinical effect, toxic and side effect, medication compliance were compared among the three groups. Results A total of 11 patients dropped out of this study because of intolerance to continue treatment caused by gastrointestinal reactions, including 8 cases of A group,2 cases of B group,1 case of C group. No statistically significant differences of short-term clinical effect was found among the three groups（ u = 0. 341,P = 0. 843）. The incidence of Ⅲ-Ⅳ grade nausea and vomiting of A group was statistically significantly higher than that of B group,C group,respectively（ P〈0. 05）. No statistically significant differences of incidence of Ⅱ-Ⅲ grade decreased WBC or Ⅰ-Ⅲ grade alopecia was found among the three groups（ P〈0. 05）. The medication adherence rate of A group was statistically significantly lower than that of B group,C group,respectively（ P〈0. 05）. Conclusion Successive medication of cisplatin（ 3 or 5 days）combined with etoposide has certain short-term clinical effect on extensive small cell lung cancer,is with mild gastrointestinal reactions and good medication compliance compared with large-dose one-time medication.