NIP与EP方案一线治疗167例晚期复合性小细胞肺癌的回顾性分析  

Navelbine-ifosfamide-cisplatin versus etoposide-cisplatin as the first-line treatment of advanced combined small-cell lung cancer:retrospective analysis of 167 cases

作　　者：罗洁[1] 李爱武[1] 吴凤英[1] 郑迪[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：《肿瘤》2012年第3期194-198,共5页Tumor

摘　　要：目的:比较NIP方案(长春瑞滨+异环磷酰胺+顺铂)和EP方案(依托泊苷+顺铂)一线治疗晚期复合性小细胞肺癌的疗效和不良反应。方法:回顾性分析2006年1月—2010年12月167例晚期复合性小细胞肺癌患者(Ⅲ～Ⅳ期),其中NIP方案组76例,EP方案组91例。所有患者均接受2～6周期的化疗。每2个化疗周期评价1次疗效。主要研究终点为总生存(overall survival,OS),次要研究终点为疾病无进展时间(progression-freesurvival,PFS)、客观有效率(objective responserate,ORR)和安全性。结果:NIP方案组ORR为28.9%(22/76),EP方案组ORR为40.7%(37/91),差异无统计学意义(P=0.115);NIP方案组中位PFS为5.8个月,EP方案组中位PFS为6.5个月,差异无统计学意义(P=0.177);NIP方案组中位生存期和1年OS分别为9.8个月和35.5%(27/76),EP方案组中位生存期和1年OS分别为10.8个月和49.4%(45/91),EP方案组较NIP方案组有更佳的生存获益,但差异无统计学意义(P=0.883,P=0.090)。不良反应2组均可耐受,NIP方案组Ⅰ～Ⅱ度中性粒细胞减少和脱发发生率均高于EP方案组(32.9%vs11.0%,P<0.001;35.5%vs13.2%,P<0.001)。结论:NIP方案治疗晚期复合性小细胞肺癌的ORR、PFS和OS均略低于EP方案组,但差异无统计学意义;不良反应可以耐受。由此提示,对于3药联合化疗在晚期复合性小细胞肺癌中的地位和作用还有待商榷。Objective：A retrospective study was performed to compare the efficacy and adverse effects between NIP regimen（navelbine ＋ ifosfamide ＋ cisplatin） and EP regimen（etoposide＋cisplatin） as the first-line treatment of advanced combined small-cell lung cancer.Methods：A retrospective study was performed in 167 patients with advanced combined small-cell lung cancer（stages Ⅲ-Ⅳ） eligibly enrolled between January 2006 and December 2010.These patients received NIP regimen（n = 76） or EP regimen（n = 91） as the first-line treatment of advanced combined small-cell lung cancer.All the patients received 2-6 cycles of chemotherapy,and the response was evaluated every two cycles.The primary endpoint was overall survival（OS）,and the secondary endpoints were progression-free survival（FPS）,objective response rate（ORR） and adverse effects.Results：There was no significant difference in ORR between the NIP group（28.9%,22/76） and the EP group（40.7%,37/91）（P = 0.115）.The median PFS of the EP group was little longer than that of the NIP group（6.5 vs 5.8 months,P = 0.177）.The median survival and one-year survival rates of the NIP group and the EP group were 9.8 months and 35.6%（27/76）,and 10.8 months and 49.4%（45/91）,respectively;the EP regimen exerted a better survival benefit than the NIP regimen,but it failed to reach a statistical difference（P = 0.883;P = 0.090）.The adverse effects of the two regimens could both be well tolerated.The rates of grade Ⅰ/Ⅱ leucopenia and alopecia for the NIP regimen were both significantly higher than those for the EP regimen（32.9% vs 11.0%,P0.001;35.5% vs 13.2%,P0.001）.Conclusion：The ORR,PFS and OS for NIP regimen are little inferior to those of EP regimen as the first-line treatment of advanced combined small-cell lung cancer,but the differences are not significant.The toxicity of NIP regimen is less tolerable as compared with EP.Thus,the role of NIP regimen in the first-line treatment of advanced combined small-cell lung

关 键 词：复合性小细胞癌 肺 抗肿瘤联合化疗方案 生存分析 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]