伊立替康与拓扑替康分别联合奈达铂治疗小细胞肺癌的疗效及安全性比较

Study of the efficacy and safty of irinotecan combined with nedaplatin versus topotecan combined with nedaplatin in treatment of small lung cancer

目的:本研究旨在比较伊立替康(CPT)与拓扑替康(TPT)分别联合奈达铂(NDP)治疗广泛期小细胞肺癌的临床疗效及安全性。方法:前瞻性分析了89例广泛期小细胞肺癌患者,其中44例CPT+NDP组,45例TPT+NDP组,两组均以3周为1个周期,至少化疗两个周期,CPT+NDP组第1天静脉注射奈达铂80 mg/m^2,第1、8、15天静脉注射伊立替康60 mg/m^2;TPT+NDP组第1天静脉注射奈达铂80 mg/m^2,第1~5天静脉注射拓扑替康1.2 mg/m^2,比较两组的临床有效率(RR),疾病控制率(DCR),中位总生存期(OS),中位无进展生存期(OS)和不良反应的差异。结果:两组的RR分别为36.36%和37.78%,DCR分别为72.73%和66.67%,无统计学差异(P>0.05),表明两组的近期疗效相似。两组的中位无进展生存期分别为6.5个月和5.8个月,中位总生存期分别为12.0个月和11.2个月,两组无统计学差异(P>0.05),表明两组远期疗效相似。CPT+NDP组腹泻和中性粒细胞减少的不良反应重于TPT+NDP组(P<0.05),而TPT+NDP组白细胞减少和血小板减少的不良反应重于CPT+NDP组(P<0.05)。结论:CPT+NDP组及TPT+NDP组治疗广泛期小细胞肺癌的近期、远期疗效相似,前者不良反应以腹泻和中性粒细胞减少为主,后者不良反应以白细胞和血小板减少为主,但均能耐受,可根据患者身体具体情况选择药物。

AIM：To compare the efficacy and safety between irinotecan（CPT） and topotecan（TPT） combined with nedaplatin（NDP） in the treatment of extensive small cell lung cancer.METHODS：Eighty-nine cases of patients who have been diagnosed as extensive small cell lung cancer were analyzed,in which 44 cases received CPT ＋NDP while the other 45 cases received TPT ＋ NDP as chemotherapy.Three weeks are one treatment course,every patient in two groups accepted more than 2 periods of chemotherapy.On the first day of each course,they received intravenous drip with LBP 30 mg/m^2.In addition,CPT ＋ NDP group was given intravenous drip with NDP 80 mg/m^2 on the first day and CPT 60 mg/m^2 on the first eighth,fifteenth day,while TPT ＋ NDP group was given intravenous drip with NDP 80 mg/m^2 on the first day and TPT 1.2 mg/m^2 on the first to fifth day.Comparison was made between the clinical response rate（RR）,disease control rate（DCR）,median overall survival,median progression-free survival and adverse reactions between the two groups.RESULTS：The RR of the two groups were 36.36% and 37.78%,the CDR of the two groups were 72.73% and 66.67%.There was no significant differences between the two groups（P〈0.05）.The median overall survival of the two groups were 12.0 months and 11.2 months,the median progression-free survival were 6.5 months and 5.8 months weeks,there are also no differences between the two groups（P〉0.05）.The CPT ＋ NDP group was milder than the TPT ＋NDP group in the leukopenia and the thrombopenia（P〈0.05）,while more severe than the TPT group in the diarrhea and neutrophilic（P〈0.05）.CONCLUSION：The curative effect of CPT combined with NDP is similar with the TPT combined with NDP on the treatment of extensive small cell lung cancer patients.The main adverse reaction of the former one is diarrhea and neukopenia,while the latter one is leukopenia and thrombopenia.Therapeutic regimen should be chosen according to the patients＇ physical condition.