伊立替康联合洛铂或卡铂二线治疗广泛期小细胞肺癌94例临床观察  

Clinical Study of Irinotecan Combined with Lobaplatin or Carboplatin as Second-line Treatment for Ninety-four Cases with Advanced Small Cell Lung Cancer

作　　者：邬麟[1] 蒲兴祥[1] 王倩之[1] 汪安兰[1] 曹军[1] 徐芳[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院(湖南省肿瘤医院),湖南长沙410013

出　　处：《肿瘤学杂志》2013年第11期872-876,共5页Journal of Chinese Oncology

摘　　要：[目的]比较伊立替康(CPT-11)联合洛铂(LBP)(IL方案)或联合卡铂(CBP)(IC方案)二线治疗广泛期小细胞肺癌(SCLC)的疗效、不良反应和总生存。[方法]94例一线化疗后进展的广泛期SCLC患者,二线治疗随机接受IL方案和IC方案化疗。其中IL方案组48例患者,采用CPT-1190mg/m2,静滴,d1,8,LBP 30mg/m2,静滴,d1;IC方案组46例患者,CBP AUC=5,静滴d1,CPT-11用药同前。上述方案每21d重复,至少接受1个周期化疗。[结果]IL方案组和IC方案组患者的总有效率(RR)、疾病控制率(DCR)分别为54.2%(26/48)、32.6%(15/46)和70.8%(34/48)、60.9%(28/46),IL方案组的RR高于IC方案组(P=0.040),两组的DCR无明显差异(P=0.385);IL和IC方案组的中位无进展生存期(PFS)分别为3.3个月和2.8个月,差异无统计学意义(P=0.127)。IL和IC方案组的总生存期(OS)分别为7.1个月和6.6个月,差异无统计学意义(P=0.203)。两组常见的不良反应为血液学毒性、恶心、呕吐、腹泻及疲乏,IL方案组的血液学毒性谱与IC方案组不同。[结论]CPT-11联合LBP二线治疗广泛期SCLC近期疗效高于联合CBP,不良反应可耐受,值得进一步研究。[Purpose] To compare the efficacy,safety and overall survival of IL regimen consisted of irinotecan（CPT-11） combined with Lobaplatin（LBP） and IC regimen consisted of CPT-11 combined with carboplatin（CBP） as second-line chemotherapy for the patients with extensive small cell lung cancer（SCLC）.[Methods] Ninety-four cases with cases of extensive SCLC who failed in the first-line chemotherapy were randomized received second-line chemotherapy with IL regimen or IC regimen respectively. In the IL regimen group,48 patients were administrated intravenously with CPT-11 90 mg/m2on d1and d8,LBP 30mg/m2on d1,while in IC regimen group,46 patients received CPT-11 at the same dose and CBP AUC=5. Each cycle was repeated every 21 days and the patient must receive at least 1cycles for evaluation. [Results] The response rate（RR） and disease control rate（DCR） in IL regimen group and IC regimen group were 54.2%（26/48）,32.6%（15/46） and 70.8%（34/48）,60.9%（28/46） respectively. The RR in IL regimen group was higher than that in IC regimen group（P=0.040）,and the DCR in two groups did not show significant difference（P=0.385）. The progression free survival（PFS）was 3.3 months in IL regimen group and 2.8 months in IC regimen group,with no significant difference（P=0.127）. The OS were 7.1 months in IL regimen group and 6.6 months in IC regimen group,with no significant difference（P=0.203）. The major toxicities were hematologic toxicities,nausea and vomiting,diarrhea,fatigue and alopecia. There were different spectrum of hematologic toxicities in IL regimen group and IC regimen group. [Conclusion] CPT-11 combined with LBP was more effective than CPT-11 combined with CBP for the second-line chemotherapy of the patients with extensive SCLC. It was a well tolerated regimen and worth further study.

关 键 词：洛铂 伊立替康 卡铂 小细胞肺癌 药物疗法 

分 类 号：R734.2[医药卫生—肿瘤]