长春地辛与长春新碱治疗视网膜母细胞瘤的临床分析

Clinical effect analysis of vindesine and vincristine in the treatment of retinoblastoma

目的对比长春地辛、长春新碱分别与卡铂、依托泊苷组成的CEV化疗方案治疗视网膜母细胞瘤的临床效果及相关不良反应发生情况,分析在长春新碱出现供货问题时采用长春地辛替代的可行性。方法 36例视网膜母细胞瘤并采用CEV方案化疗的患儿,根据不同的化疗药物分为长春新碱组(25例)和长春地辛组(11例)。长春新碱组采用长春新碱+依托泊苷+卡铂进行治疗,长春地辛组采用长春地辛+依托泊苷+卡铂进行治疗,比较并评价两组治疗效果及不良反应。结果长春新碱组患儿有效率为76.0%,疾病控制率为92.0%;长春地辛组患儿有效率为81.8%,疾病控制率为90.9%。两组患儿的有效率和疾病控制率比较差异无统计学意义(P>0.05)。长春地辛组在骨髓抑制方面(白细胞减少、贫血、血小板减少)的不良反应发生率高于长春新碱组,差异有统计学意义(P<0.05)。长春新碱组与长春地辛组在胃肠道反应、肝功能异常、脱发、外周神经毒性方面的不良反应发生率比较差异无统计学意义(P>0.05)。结论长春地辛代替长春新碱的CEV化疗方案治疗视网膜母细胞瘤安全、有效,但需关注并及时处理其骨髓抑制方面的不良反应。

Objective To compare and analyze curative effect and adverse reactions of vindesine and vincristine combined with carboplatin, etoposide, in the treatment of retinoblastoma, and to analyze feasibility of vindesine in replacement of vincristine in shortage of supplement. Methods A total of 36 retinoblastoma children treated with CEV chemotherapy regimens were divided by different chemotherapy drugs into vincristine group（25 cases） and vindesine group（11 cases）. The vincristine group received vincristine ＋ etoposide ＋ carboplatin, and vindesine group received vindesine ＋ etoposide ＋ carboplatin for treatment. Comparison were made on clinical effect and adverse reactions. Results The vincristine group had effective rate as 76.0%, disease control rate as 92.0%, and vindesine group had effective rate as 81.8%, disease control rate as 90.9%, and there were no statistical significant differences in effective rate and disease control rate between two groups（P〉0.05）. The vindesine group had higher incidence of adverse reaction in myelosuppression（leucopenia, anemia and thrombocytopenia） than vincristine group, and difference had statistical significance（P〈0.05）. There were no statistical significant differences in adverse reactions of gastrointestinal reactions, liver dysfunction, alopecia and neurotoxicity and peripheral neurotoxicity in two groups（P〉0.05）. Conclusion CEV chemotherapy regimens with vindesine instead of vincristine proves to be a safe and effective method in the treatment of retinoblastoma, and adverse reactions on myelosuppression should be concerned and handled in time.