伊立替康联合奈达铂与拓扑替康联合奈达铂治疗小细胞肺癌的临床效果比较

Clinical effects of irinotecan plus nedaplatin and topotecan plus nedaplatin on small cell lung cancer

目的比较伊立替康联合奈达铂与拓扑替康联合奈达铂治疗小细胞肺癌的临床效果。方法选择2016年12月至2017年12月于成都军区总医院住院治疗的小细胞肺癌患者118例,应用随机数字表法分为观察组和对照组,各59例。对照组给予伊立替康联合奈达铂进行二线化疗,观察组采取拓扑替康联合奈达铂进行二线化疗。2组均以3周为1个治疗周期,共治疗3个周期。观察治疗前和治疗3个周期后患者肝功能的变化,记录治疗过程中的毒副作用和不良反应,治疗3个周期后对2组患者进行疗效评估,比较1、2、3年的生存率。结果治疗前,2组患者的肝功能比较差异均无统计学意义(均P>0.05)。治疗后观察组和对照组患者的丙氨酸转氨酶和天冬氨酸转氨酶均低于治疗前,且观察组低于对照组[(38±3) U/L比(59±5) U/L,(54±7) U/L比(80±8) U/L],差异均有统计学意义(均P <0.001)。观察组毒副作用分级低于对照组,不良反应发生率低于对照组[17. 0%(10/59)比44. 1%(26/59)],差异均有统计学意义(均P<0.001)。治疗3个周期后,观察组客观缓解率和疾病控制率均高于对照组[61. 0%(36/59)比37. 3%(22/59),93. 2%(55/59)比83. 0%(49/59)],差异均有统计学意义(均P <0. 001)。观察组患者1、2、3年存活率均显著高于对照组[61. 0%(36/59)比40.7%(24/59),39.0%(23/59)比25. 4%(15/59),28. 8%(17/59)比11.9%(7/59)],差异均有统计学意义(均P <0.001)。结论拓扑替康联合奈达铂对小细胞肺癌进行二线化疗的临床效果明显优于伊立替康联合奈达铂。

Objective To analyze the clinical effects of irinotecan plus nedaplatin and topotecan plus nedaplatin on small cell lung cancer. Methods A total of 118 patients with small cell lung cancer were enrolled in Chengdu Military General Hospital from December 2016 to December 2017. The patients were divided into observation group and control group, with 59 cases in each group. The control group was treated with irinotecan plus nedaplatin second-line chemotherapy; the observation group was treated with topotecan plus nedaplatin second-line chemotherapy; 1 course of chemotherapy was 3 weeks; both groups were treated for 3 courses. Liver function indexes were detected before and after therapy. Toxic and side effects were observed. Clinical efficacy was analyzed. Survival condition of patients was analyzed 1, 2, 3 years after therapy. Results Before chemotherapy, liver function indexes showed no significant differences between groups（P〉0.05）. After therapy, levels of alanine aminotransferase and aspartate aminotransferase were significantly lower than those before therapy in both groups; the levels in observation group were significantly lower than those in control group[（38±3）U/L vs （59±5）U/L, （54±7）U/L vs （80±8）U/L]（P〈0.001）. Toxic effect grade in observation group was lower than that in control group; incidence of adverse reactions in observation group was lower than that in control group[17.0%（10/59） vs 44.1%（26/59）]（P〈0.001）. After therapy, objective remission rate and disease control rate in observation group were significantly higher than those in control group[61.0%（36/59） vs 37.3%（22/59）, 93.2%（55/59） vs 83.0%（49/59）]（P〈0.001）. The 1-, 2-, 3-year survival rates in observation group were significantly higher than those in control group[61.0%（36/59） vs 40.7%（24/59）, 39.0%（23/59） vs 25.4%（15/59）, 28.8%（17/59） vs 11.9%（7/59）]（P〈0.001）. Conclusion Second-line chemotherapy with topotecan plus nedaplatin shows a better curative effect on small cell lung cancer than irinotecan plus nedaplatin.