和美新二线治疗肺癌的初步临床观察

Second-line Hycamtin in the treatment of lung cancer

目的 观察和美新 (盐酸托泊替康 )二线治疗肺癌的疗效及毒副反应。方法 2 1例患者均为二线用药。其中未行手术者 11例 ,均为复治患者 ;行手术切除者 8例 ,开胸探查 2例 ,均于术后予以和美新化疗。和美新 1.2mg·(m2 ) 1·d 1,静脉点滴 30min ,连续 4d ,2 1d为一个周期。根据患者不同情况 ,给予 1～ 4个周期的治疗。 2 1例患者中 ,4例行顺铂 (PDD) 6 0mg/m2 ,d 1,联合化疗。结果2 1例患者中 ,未行手术与仅行开胸探查者 13例 ,其中CR 2例 ,PR 6例 ,SD 3例 ,PD 2例 ,有效率6 1.5 %。行手术切除的 8例中 ,术后应用和美新治疗后病情稳定 7例 ,另 1例出现远处转移。全组中位生存期 16个月 ,1年生存率为 88.2 %。血液系统毒性 :Ⅰ～Ⅱ级白细胞减少者 14例 (6 6 .7% ) ,Ⅲ～Ⅳ级白细胞减少 5例 (2 3.8% ) ;Ⅲ～Ⅳ级血小板减少 1例 (4 .8% ) ;患者发热和中性粒细胞减少 1例 ;1例因严重骨髓抑制而死亡。非血液学毒性中 ,恶心 8例 (38.1% ) ,呕吐 3例 (14 .3% ) ,脱发 4例(19.1% ) ,腹痛 1例 (4 .8% ) ,腹泻 2例 (9.5 % ) ,便秘 1例 (4 .8% )。结论 和美新二线治疗肺癌有效 ,尤其是小细胞肺癌 ,毒副反应可耐受 ,可用于复治或耐药的肺癌患者。

Objective To discuss the therapeutic effect and toxicity of second line Hycamtin for lung cancer patients. Methods Ten of these 21 patients had been treated with operation. All these 21 patients received second line Hycamtin treatment; given at the dose of 1.2 mg/m 2 per day, four consecutive days as one cycle and 21 days as one course. A total of 1 4 courses were given according to the patient′s tolerance. Four of these 21 patients also received combination of cisplatin. Results Among the 13 un operated patients, two patients showed CR, six showed PR, three SD and two PD, giving an effective rate of 62%. Among the 8 operated patients, seven showed SD but one developed distant metastasis. The 1 year survival rate was 88%. Toxicity: leukopenia Ⅰ Ⅱ degree 14 (66.7%), leukopenia Ⅲ Ⅳ degree 5(23.8%), thromb cytopenia Ⅲ Ⅳ degree 1 (4.8%) and one patient died of high fever and neutocytopenia. Nausea 8(38.1%), vomiting 3(14.3%) and diarnhea 2(9.5%) alopecia 4(19.1%). Were the other side effects. Conclusion Hycamtin is indicated for second line therapy for lung cancer giving tolerable toxicity.