替尼泊甙联合顺铂与足叶乙甙联合顺铂治疗小细胞肺癌的疗效比较  

Teniposide and Cisplatin Compared with Etoposide and Cisplatin for Treatment of Small Cell Lung Cancer

作　　者：范云[1] 黄志煜[1] 张沂平[1] 孙琳[1] 

机构地区：[1]浙江省肿瘤医院化疗中心,浙江杭州310022

出　　处：《癌症》2002年第12期1368-1371,共4页Chinese Journal of Cancer

摘　　要：背景与目的:足叶乙甙(VP-16)联合顺铂(DDP)组成的EP方案是治疗小细胞肺癌(smallcelllungcancer,SCLC)的标准方案之一,但治愈率较低;替尼泊甙(VM-26)具有与VP-16同等的抗癌活性,且能通过血脑屏障。本研究的目的是观察比较VM-26联合DDP方案与EP方案治疗SCLC患者的疗效及对脑转移的预防作用。方法:70例初治、无脑转移的SCLC患者接受治疗,其中VM-26+DDP方案(VM-26组)34例,EP方案(VP-16组)36例,病人一般特征经χ2检验,两组具有可比性(P>0.05)。结果:VM-26组CR12例,PR14例,NC6例,PD2例,有效率76.5%,中位生存期10.4个月,1、2、5年生存率分别为35.3%、14.7%、8.8%;VP-16组CR12例,PR13例,NC8例,PD3例,有效率69.4%,中位生存期9.8个月,1、2、5年生存率分别为38.9%、13.9%、8.3%。两组有效率及生存期均无统计学差异(P>0.05)。VM-26组脑转移率为5.9%,VP-16组为19.4%,VP-16组明显高于VM-26组,有统计学差异(P=0.027)。不良反应主要为骨髓抑制,多为Ⅰ、Ⅱ度,两组比较无统计学差异(P>0.05)。过敏反应VM-26组高于VP-16组,有统计学差异(P=0.016)。结论:VM-26联合DDP治疗SCLC疗效肯定,其近期疗效和长期生存率与EP方案组相似;该方案对脑转移有一定的预防作用,耐受性较好,可作为初治SCLC的一线治疗方案。Background & Objective: EP regimen[etoposide (VP 16)+cisplatin (DDP)] is a standard regimen for treatment of small cell lung cancer (SCLC), but the cure rate is still low. Teniposide (VM 26) is highly active single agent for SCLC as VP 16, and penetratable through blood brain barrier. This clinical trial was designed to compare the efficacy and toxicity of teniposide plus cisplatin (VM 26+DDP) regimen and EP regimen in treatment of SCLC,and the possible role of VM 26 on prevention of brain metastasis of SCLC. Methods: A total of 70 previously untreated SCLC patients without brain metastasis were included; 34 patients received VM 26 +DDP and 36 patients received EP. The characteristics of patients were comparable according to χ2 test. Results: The overall response rate was 76.5% for VM 26 +DDP group with 12 complete response (CR) and 14 partial response (PR),and 69.4% in the EP group with 12 CR and 13 PR (P=0.595) . The median duration of survival was 10.4 months for VM 26 +DDP group versus 9.8 months for EP group (P >0.05). The 1,2,and 5 year survival rates were 35.3%,14.7%,8.8% in the VM 26+DDP group; and 38.9%,13.9%,8.3% in the EP group (P >0.05, without statistical difference). The rate of brain metastasis was 5.9% for VM 26+DDP group and 19.4% for EP group (P=0.027,with statistical difference). The main toxicity was mylosuppression(Ⅰ～Ⅱ);there was no significant difference between the two groups (P >0.05). Conclusion:VM 26+DDP is a highly active regimen for treatment of SCLC;there is no difference in the effectiveness and toxicity versus EP regimen;VM 26 is possibly effective in prevention of brain metastasis in SCLC patients.

关 键 词：治疗 疗效 小细胞肺癌 化学疗法 替尼泊甙 足叶乙甙 顺铂 不良反应 

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