伊立替康联合奈达铂二线治疗复发广泛期小细胞肺癌

Irinotecan combined with nedaplatin second-line for the treatment of recurrent extensive small cell lung cancer

目的观察伊立替康注射液联合奈达铂化疗方案二线治疗复发广泛期小细胞肺癌(SCLC)的安全性和疗效。方法 39例复发或进展的SCLC患者,采用伊立替康注射液联合奈达铂二线治疗,其中伊立替康90 mg/m2静脉滴注,d1、8,奈达铂25 mg/m2静脉滴注,d1、2、3。每28天为1个周期,每2个化疗周期后进行疗效评价。结果 39例患者均完成2个周期以上化疗,其中完全缓解(CR)5例(12.8%),部分缓解(PR)12例(30.8%),疾病稳定(SD)11例(28.2%),疾病进展(PD)11例(28.2%)。客观缓解率(ORR)为43.6%。39例患者主要毒副反应为血液学毒性和消化道反应。其中肝功能损害发生率为35.9%,均为Ⅰ、Ⅱ度;肾功能损害发生率为10.3%,均为Ⅰ、Ⅱ度;中性粒细胞减少发生率为56.4%,其中Ⅰ、Ⅱ度为25.6%,Ⅲ、Ⅳ度为30.8%;血小板减少发生率为38.5%,其中Ⅰ、Ⅱ度为30.8%,Ⅲ、Ⅳ度为7.7%;血红蛋白下降发生率为23.1%,其中Ⅰ、Ⅱ度为15.4%,Ⅲ、Ⅳ度为7.7%;发热发生率为12.8%,其中Ⅰ、Ⅱ度为7.7%,Ⅲ、Ⅳ度为5.1%;疲乏发生率为23.1%,均为Ⅰ、Ⅱ度;恶心呕吐发生率为56.4%,其中Ⅰ、Ⅱ度为41.0%,Ⅲ、Ⅳ度为15.4%;腹泻发生率为46.2%,其中Ⅰ、Ⅱ度为38.5%,Ⅲ、Ⅳ度为7.7%。全组无毒性相关死亡。结论伊立替康联合奈达铂化疗方案二线治疗复发性广泛期SCLC有一定的安全性和疗效。

Objective To observe the safety and efficacy of irinotecan injection combined with nedaplatin second-line chemotherapy in the treatment of recurrent extensive small cell lung cancer（SCLC）. Methods A total of 39 patients with recurrent or progressive SCLC were treated with irinotecan injection combined with nedaplatin second-line therapy, including intravenous infusion of irinotecan 90 mg/m2 at d1 and d8, intravenous infusion of nedaplatin at d1, d 2, d3. Every 28 days for a cycle, and the efficacy was evaluated after every 2 cycles of chemotherapy. Results 39 patients completed 2 cycles of chemotherapy, including 5 complete remission（CR） cases（12.8%）, 12 partial remission（PR） cases（30.8%）, 11 stable disease（SD） cases（28.2%）, 11 disease progression（PD） cases（28.2%）, with objective remission rate（ORR） as 43.6%. The main toxic and side effects of 39 patients were hematological toxicity and digestive tract reaction. The incidence of liver function damage was 35.9%, all of which were Ⅰ and Ⅱ degree, and the rate of renal function damage was 10.3%, which were all Ⅰ and Ⅱ degree. The incidence of neutrophils was 56.4%, with Ⅰ and Ⅱ degree as 25.6%, and Ⅲ and Ⅳ degree as 30.8%. The incidence of thrombocytopenia was 38.5%, with Ⅰ and Ⅱ degree as 30.8%, and Ⅲ and Ⅳ degree as 7.7%. The incidence of hemoglobin decline was 23.1%, with Ⅰ and Ⅱ degree as 15.4%, and Ⅲ and Ⅳ degree as 7.7%. The incidence of fever was 12.8%, with Ⅰ and Ⅱ degree as 7.7%, and III and Ⅳ degree as 5.1%. The incidence of fatigue was 23.1%, all of which were Ⅰ and Ⅱ degree. The incidence of nausea and vomiting was 56.4%, with Ⅰ and Ⅱ degree as 41.0%, and Ⅲ and Ⅳ degree as 15.4%. The incidence of diarrhoea was 46.2%, with Ⅰ and Ⅱ degree as 38.5%, and III and Ⅳ degree as 7.7%. There was no toxic related deaths in this group. Conclusion Combination of irinotecan and nedaplatin second-line chemotherapy provides certain safety and efficacy in treating recurrent extensive.