依立替康联合顺铂二线治疗小细胞肺癌  

Combination chemotherapy with irinotecan and cisplatin as second-line treatment for small cell lung cancer

作　　者：罗洁[1] 徐瑛[1] 周崧雯[1] 李爱武[1] 郑迪[1] 徐建芳[1] 周彩存[1] 

机构地区：[1]同济大学附属上海市肺科医院肿瘤科,上海200433

出　　处：《中国癌症杂志》2007年第11期887-890,共4页China Oncology

摘　　要：背景与目的：小细胞肺癌（small cell lung cancer,SCLC）一线化疗疗效较好,然而一旦复发,治疗十分困难,目前尚未确定最佳二线化疗方案。因此,我们采用依立替康（irinotecan,CPT-11）联合顺铂（cisplatin,DDP）二线治疗SCLC,以探讨其疗效与安全性。方法：对30例既往经一线化疗方案治疗失败的SCLC患者采用CPT-1160mg/m^2,静滴,第1、8、15天;DDP25mg/m^2,静滴,第1～3天。28d为1个周期,2个周期后进行一次疗效评价,4周后复核并随访生存期。结果：可评价病例28例,其中CR1例,PR7例,SD8例,PD12例,有效率28.6%（8/28）。中位疾病进展时间（time to progression,TTP）为3.2个月（0.8～5.6个月）,二线治疗生存期7.5个月（1.5～31个月）,可使总体生存期达到15个月（2.3～43.5个月）。主要不良反应为血液毒性,Ⅲ～Ⅳ度中性粒细胞下降36.7%（11/30）,其次是肝功能损害,仅1例出现Ⅲ度腹泻。结论：CPT-11联合DDP二线治疗SCLC是可行、安全及有效的。Background and purpose：Small cell lung cancer is highly sensitive to first-line chemotherapy.But most patients are destined to relapse and the results of second-line chemotherapy are usually poor.There was no generally accepted approach for second-line treatment.So we wanted to investigate the efficacy and safety of irinotecan plus cisplatin in patients with small cell lung cancer as second-line chemotherapy.Methods：Thirty patients who have previously failed first-line chemotherapy received irinotecan 60 mg/m2 on days1,8,15,followed by cisplatin 25 mg/m2 on day 1-3,and 28 days was one cycle.Objective response was evaluated every two cycles and overall survival were followed up.Results：In evaluable 28 patients,CR 1 cases,PR 7cases,SD 8 cases,and PD 12 cases.The response rate was 28.6%（8/28）.Median TTP was 3.2 months（0.8-5.6 m）.Median survival after second-line treatment was 7.5 months（1.5-31 m）and overall survival was 15 months（2.3-43.5 m）.Hematological toxicity was the most commonly adverse effect,grade Ⅲ-Ⅳ neutroperia was 36.7%（11/30）.Hepatic toxicity was another main side effect,and only one patient developed grade Ⅲ diarrhea.Conclusions：The combination of irinotecan and cisplatin is feasible,effective,and safe for SCLC as second-line treatment.

关 键 词：肺肿瘤 小细胞肺癌 依立替康 二线化疗 

分 类 号：R730.53[医药卫生—肿瘤] R734.2[医药卫生—临床医学]