IP方案在治疗重症小细胞肺癌的疗效观察

Clinical Observation of Irinotecan plus Platinum Regimen for the Severe Small-cell Lung Cancer

目的:探讨伊立替康联合铂类药物(IP)方案治疗合并呼吸功能不全或肝功能不全的重症小细胞肺癌患者,在抢救性化疗中的疗效和安全性。方法:收集我院肿瘤科收治的合并肿瘤相关性肝功能衰竭或肿瘤相关性呼吸衰竭的重症小细胞肺癌患者,用IP方案(卡铂AUC 5 d1或顺铂20 mg·m-2d1,2,3/伊立替康50 mg·m^(-2)d1,8,15 q4w)进行抢救性化疗,对有效的患者维持6周期后进行疗效及副作用评价。结果:共有13名患者纳入本研究,1例CR,6例PR,3例SD,3例PD,客观有效率为76.92%,总疾病缓解率53.85%;3/4级不良反应:白细胞减少3例,血小板减少2例,腹泻2例,恶心、呕吐5例。结论:在合并肝或肺功能不全的重症小细胞肺癌中,IP方案有很好的疗效及安全性,推荐作为重症小细胞肺癌的首选治疗方案。

Objective： To investigate the efficacy and safety of IP regimen （irinotecan combined with platinum-based drugs）in patients with severe small cell lung cancer （SCLC） complicated with respiratory insufficiency or hepatic insufficiency in rescue chemotherapy. Methods ： Patients with severe SCLC were treated with IP regimen （ carboplatin AUC 5 dl or cisplatin 20 mg·m^-2 d1, 2, 3/irinotecan 50 mg · m^-2 d1, 8,15 q4w） for the treatment of tumor associated liver failure or tumor related respiratory failure for rescue chemotherapy, the effective patients to maintain 6 cycles after the efficacy and side effects evaluation. Results： A total of 13 patients were included in this study, 1 CR, 6 PR, 3 SD, 3 PD, the objective response rate （ORR） was 76. 92% , total disease remission rate （RR） was 53.85% ; grade 3/4 adverse reactions ： neutrupenia（3/13 ）, thrompovytopenia（2/13）, diarrhea（2/13 ）, nausea and vomiting （ 5/13 ）. Conclusion：IP regimen has a good efficacy and safety in patients with severe SCLC complicated with hepatic or pulmonary insufficiency. It is recommended as the first choice for treatment of severe SCLC.