伊立替康联合顺铂与紫杉醇联合顺铂二线治疗小细胞肺癌的临床观察  

Comparative Study of Combined Chemotherapy between Irinotecan plus Cisplatin Regimen and Pachtaxel plus Cisplatin Regimen in Second-line Treatment for Small Cell Lung Cancer

作　　者：陈思林[1,2] 付曦[1,2] 别俊[1,2] 赵彩霞[1,2] 

机构地区：[1]川北医学院第二临床医学院 [2]南充市中心医院肿瘤中心,四川南充637000

出　　处：《肿瘤预防与治疗》2012年第6期357-360,共4页Journal of Cancer Control And Treatment

摘　　要：目的:观察伊立替康联合顺铂(IP组)与紫杉醇联合顺铂(TP组)周剂量方案二线治疗复发或进展期小细胞肺癌的疗效及不良反应。方法:共96例EP(依托泊甙联合顺铂)方案或CAV方案(环磷酰胺、表柔比星联合长春新碱)化疗后复发或进展的小细胞肺癌患者,采用信封法随机分组进入IP组49例和TP组47例接受治疗。IP组:伊立替康60mg/m^2,第1,8,15天;顺铂25mg/m^2,第1天～3天,静滴。TP组:紫杉醇60mg/m^2,第1,8,15天;顺铂25mg/m^2,第1天～3天,静滴;均为28天1个周期,每2周期评价一次疗效。结果:IP组49例,有效率36.7%(18/49);TP组47例,有效率34%(16/47),两组近期疗效差异无统计学意义(P>0.05)。两组中位生存期(MST)均为37.0周,差异无统计学意义(P>0.05)。两组毒副作用主要表现为:Ⅲ度～Ⅳ度白细胞减少,TP组高于IP组(34.0%vs 22.4%,P<0.05);Ⅲ度～Ⅳ度血小板减少TP组高于IP组(17.0%vs 10.2%,P<0.05);延迟性腹泻IP组高于TP组(22.4%vs 6.4%,P<0.01)。结论:伊立替康联合顺铂与紫杉醇联合顺铂周剂量方案二线治疗小细胞肺癌近期疗效较好,毒副作用可以耐受,值得进一步研究。Objective： To compare the efficacy and toxicity between IP （ irinotecan plus eisplatin） and TP （ paclitaxel plus cisplatin） regimen in the second-line treatment for recurrent small cell lung cancer. Methods： Of 96 patients with SCLC, forty-nine ca- ses were treated with IP regimen（ irinoteean 60 mg/m^2 , d1,8,15, cisplatin 25mg/m^2 d1-3, intravenously） and 47 cases were treated with TP regimen（paclitaxel 60mg/m^2 , d1,8,t5, cisplatin 25mg/m^2 d1 -3, intravenously）, twenty-eight days as one cycle. The efficacy and toxicities were evaluated after two cycles. Results： The overall response rate was 36. 7% （18/49） and 34% （16/47） in IP group and TP group respectively. No significant difference was observed（ P 〉 0. 05 ）. The median survival time was 37 weeks in the two groups without significant differeuce（P 〉0. 05 ）. Incidence of III - IV grade leucocytopenia of TP regimen was higher than that of IP regimen （ 34. 0% versus 22. 4% , P 〈 0. 05 ）. Incidence of III - IV grade thrombocytopenia of TP regimen was higher than that of IP regimen（ 17.0% versus 10. 2% ,P 〈 0. 05 ）. Incidence of delayed diarrhea of IP regimen was higher than that of TP regimen（22. 4% versus 6. 4% , P 〈 0. 01 ）. Conclusion： TP and IP regimen in the second-line treatment for recurrent SCLC both have good short-term clinical efficacv and the side reactions were tolerable.

关 键 词：伊立替康 紫杉醇 小细胞肺癌 联合化疗 

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