替莫唑胺治疗老年广泛期小细胞肺癌疗效观察

The efficacy of temozolomide capsule in the treatment of extensive small cell lung cancer in the elderly patients

目的:观察对于60～85岁老年广泛期小细胞肺癌(small cell lung cancer,SCLC)患者给予一线化疗药物治疗后6月内复发后二线化疗药物临床疗效及耐受性。方法:选取2013年1月至2017年1月间在研究中心就诊的经过EP方案一线治疗后6月内复发的老年广泛期小细胞肺癌患者44例,分为替莫唑胺组(n=22)和对照组(n=22)。替莫唑胺组给予替莫唑胺每天150 mg/m^2,连续服用5天,28天为一周期。对照组给予伊立替康65 mg/m^2,d1、8+顺铂75 mg/m^2分3天,d2～4,静脉输注。2周期复查评价治疗效果。对比两组有效率、疾病控制率、无进展生存期及不良反应发生率。结果:替莫唑胺组与对照组的有效率、疾病控制率分别为18%vs 18%、23%vs 27%,差异无统计学意义(P> 0. 05);替莫唑胺组与对照组的无进展生存时间分别为5. 3个月和5. 5个月,差异无统计学意义(P> 0. 05);替莫唑胺组的胃肠道反应、腹泻及骨髓抑制明显低于对照组,差异有统计学意义(P <0. 05)。结论:替莫唑胺口服28天一周期方案化疗有效率高,老年患者耐受性好,是经一线治疗后6月内复发的老年广泛期小细胞肺癌患者值得选择的化疗方案。

Objective： To evaluate the efficacy and toxicity of temozolomide capsule used for patients who had relapsed after first-line chemotherapy drugs within 6 months of extensive small cell lung cancer in the elderly patients,whose age was from 60 to 85 years. Methods： 44 elderly patients with extensive small cell lung cancer diagnosed in our hospital,with recurrence within 6 months after receiving first-line treatment（ EP） were collected. The patients were randomly divided into 2 groups. Temozolomide group（ 22 patients） received 2 cycles. One cycle included 28 days（ temozolomide 150 mg/m^2 per day,continuous taking for 5 days）. Control group（ 22 patients） received CPT-P chemotherapy（ irinotecan 65 mg/m^2,d1,8,intravenously. Cisplatin 75 mg/m^2,3 days,d2 ～ 4,intravenously）. The efficacy and toxicity were evaluated after 2 cycles of treatment. Efficient rate,disease control rate,progression-free survival and incidence of adverse reactions were compared between the two groups. Results： The efficacy rates of the temozolomide group and control group were 18% and 18%. The disease control rates were 23% and 27%（ P〉0. 05）.The progression-free survival time for the temozolomide group and control group was 5. 3 months and 5. 5 months（ P〉0. 05）. The gastrointestinal reaction,diarrhea and the degree of bone marrow suppression（ grade Ⅲ-Ⅳ） of the temozolomide group were significantly lower than the control group（ P〈0. 05）. Conclusion： Temozolomide is one of the most effective chemotherapy regimens for elderly patients with extensive small cell lung cancer who relapsed within 6 months after receiving first-line treatment（ EP）. The elderly patients are well tolerated.