紫杉醇联合顺铂治疗复发性小细胞肺癌  

Combined chemotherapy of paclitaxel and cisplatin in the treatment of relapsed small cell lung cancer

作　　者：鲁军[1] 刘莉萍[1] 杨小红[1] 

机构地区：[1]湖南省肿瘤医院肿瘤内科,长沙410013

出　　处：《中国肺癌杂志》2007年第1期48-50,共3页Chinese Journal of Lung Cancer

摘　　要：背景与目的小细胞肺癌对初次化疗极其敏感,但大多数患者会出现病情进展或复发,需要二线或挽救方案治疗。本研究的目的是观察紫杉醇联合顺铂治疗复发或进展的小细胞肺癌的疗效和安全性。方法紫杉醇联合顺铂治疗41例复发或进展的小细胞肺癌。紫杉醇175mg/m^2静脉滴注,第1天,顺铂30mg/m^2静脉滴注,第1-3天,每21天为一周期。结果39例可评价疗效,完全缓解率为12.8%（5/39）,部分缓解率为46.2%（18/39）,稳定率为33.3%（13/39）,进展率为7.7%（3/39）,有效率为59.0%。中位疾病进展时间为20周,中位生存期为27周,1年生存率为10.3%（4/39）。主要不良反应为血液学毒性,Ⅲ＋Ⅳ度白细胞下降率为24.4%（10/41）,无粒细胞减少性发热,Ⅲ度血小板下降率为4.9%（2/41）,无Ⅳ度下降。恶心呕吐发生率为82.9%（34/41）,仅3例为Ⅲ度毒性,无肾毒性及严重神经毒性。全组无毒性相关死亡病例。结论紫杉醇联合顺铂作为二线方案治疗复发的小细胞肺癌有较好的疗效,不良反应可以耐受。Background and objective Small cell lung cancer （SCLC） is considered extremely sensitive to first-line chemotherapy, but most patients are destined to relapse, and need a second-line regimen. The aim of this study is to evaluate the efficacy and safety of the paclitaxel and cisplatin （PC） combination in relapsed SCLC. Methods Eligible patients were those with SCLC who had progressed or relapsed after therapy with carboplatin and etoposide （with or without chest radiotherapy）. Forty-one patients were enrolled for this study. The PC regimen consisted of paclitaxel 175 mg/m^2 on day 1 and cisplatin 30 mg/m^2 on days 1, 2, 3; PC was given every 21 days. Results In 39 evaluable patients, responses included 5 complete remissions and 18 partial remissions （overall response rate, 59.0%）, 13 patients had stable disease and 3 had progressive disease. Median time to progression and overall survival were 20 and 27 weeks, respectively. The 1-year survival rate was 10.3%. The main toxicity was hematological toxicity. Grade Ⅲ ＋ Ⅳ leukopenia was seen in 10 patients （24.4%） and no febrile neutropenia, grade Ⅲ thrombocytopenia was seen in 2 patients （4.9%）. Nausea and vomiting was seen in 34 patients （82.9%）, including 3 patients with grade Ⅲ. No grade Ⅲ＋ Ⅳ neuropathy was observed, there was no renal toxicity. There were no treatment-related deaths. Conclusion The PC combination is highly active and tolerable in patients with relapsed SCI.C when it is administered as second-line treatment.

关 键 词：紫杉醇 顺铂 小细胞肺癌 化疗 

分 类 号：R734.2[医药卫生—肿瘤]