摘要
目的研究适合实体瘤外周血干细胞动员方法,比较自体外周血干细胞解救下高剂量化疗与常规剂量化疗治疗小细胞肺癌的疗效、中位生存期,并评价与高剂量化疗有关的毒性。方法病理证实的胸部恶性肿瘤、乳腺癌28例,用低剂量GCSF动员外周血干细胞。自体外周血干细胞解救下三倍剂量的高剂量化疗治疗19例小细胞肺癌,与同期常规剂量化疗20例小细胞肺癌比较。结果低剂量GCSF动员干细胞,外周血单个核细胞(MNC)于第6天最高,第5天分离所得产物CD_(34)^+平均为3.6503×10~6/kg,能有效帮助高剂量化疗后造血功能和免疫功能恢复。高剂量化疗组缓解率为100%,中位生存期22个月,常规剂量组缓解率为85%,中位生存期8.5个月,COX单因素分析有统计学意义,P=0.039。主要毒性为骨髓抑制,无与治疗相关的死亡。结论自体外周血干细胞解救下三倍剂量高剂量化疗治疗小细胞肺癌的缓解率、中位生存期优于常规化疗组,低剂量GCSF动员外周血干细胞适合骨髓功能正常的实体瘤。
Objective The purpose is to research the simple method of mobilization of peripheral blood progenitor cell for solid tumor then to compare the response to treatment, survival of high dose chemotherapy with autologous peripheral blood stem cell rescue with conventional chemotherapy on treatment of SCLC and access treatment - related toxicity of high dose chemotherapy. Methods Using low dose of GCSF (5 -6μg/m2) mobilized peripheral blood progenitor cell for 32 times of 28 cases age≤65yrs solid tumor. 19 SCLCs were given at high dose of CTX (3.0g/m2), Vpl6 (750mg/m2), Carbaplatin (400mg/m2) and cisplatin (60mg/m2) with autologous peripheral blood stem cell rescue after 1-3 cycles of conventional chemotherapy.The compared 20 SCLCs were given 2 cycles of conventinal chemotherapy of IVP, CVpP, IVpP. Results The peak number of MNC was on the sixth by low dose of GCSF mobilized, the number of CD34+ was 3.6503 × 106/kg and 75% of collection on the fifth day of mobilized can succeed.Response to high - dose chemotherapy was 100%, to conventional - dose was 85% , P > 0.05.The medium survival is 22 M and 8.5 M respectively, The accumulated survival of HDCT was statistical better then CDCT P= 0.039.The severe toxacity of HDCT was Ⅳ degrees graulocytopenia and thrombocytopenia. Conclusions The low dose of GCSF mobilized peripheral blood progenitor cell can support high dose chemotherapy. High dose chemotherapy with rescue of autolougous peripheral blood stem cell is an effective therapy for SCLC.Compared with conventional dose response rate is increase, the accumulated survival rates is significant improve.
出处
《医学研究通讯》
2003年第3期10-13,共4页
Bulletin of Medical Research
关键词
自体外周血干细胞
高剂量化疗
治疗
小细胞肺癌
Peripheral blood stem cell rescue Mobolization High dose chemotherapy SCLC