CAJ | 학술논문

目的：观察洛铂联合伊立替康与顺铂联合伊立替康二线治疗小细胞肺癌（SCLC）的疗效及毒副作用。方法对56例SCLC患者，均为一线依托泊苷联合顺铂方案治疗失败且在3～6个月内出现进展的患者，分为洛铂组（洛铂联合伊立替康，n＝30）和顺铂组（顺铂联合伊立替康，n＝26）。洛铂组：洛铂30 mg/m2静脉滴注，第1天；伊立替康65 mg/m2静脉滴注，第1、8天；顺铂组：顺铂25 mg/m2静脉滴注，第2、3、4天；伊立替康65 mg/m2静脉滴注，第1、8天；两组均21 d为1周期，化疗2周期以上者评价疗效，对两组患者近期疗效及毒副作用进行比较，并随访疾病进展时间（TTP）、生存期（OS）。结果洛铂组30例，总有效率（RR）36．7％，疾病控制率（DCR）66．7％；顺铂组26例，RR 34．6％，DCR 65．4％，两组 RR、DCR 比较差异无统计学意义（P＞0．05）。洛铂组和顺铂组中位TTP分别为4．5个月、4．3个月，中位 OS分别为8．5个月、8．4个月，两组比较差异无统计学意义（P＞0．05）。洛铂组的主要毒副作用为骨髓抑制，顺铂组为消化道反应和骨髓抑制。洛铂组血小板减少Ⅲ～Ⅳ度较顺铂组明显，但差异无统计学意义（P＞0．05）；恶心、呕吐Ⅲ～Ⅳ度发生率顺铂组明显高于洛铂组，两组间差异有统计学意义（P＜0．05）。结论洛铂联合伊立替康二线治疗SCLC疗效确切，毒副作用可耐受；与顺铂联合伊立替康方案相比，疗效相似，值得进一步研究观察。
목적：관찰락박연합이립체강여순박연합이립체강이선치료소세포폐암（SCLC）적료효급독부작용。방법대56례SCLC환자，균위일선의탁박감연합순박방안치료실패차재3～6개월내출현진전적환자，분위락박조（락박연합이립체강，n＝30）화순박조（순박연합이립체강，n＝26）。락박조：락박30 mg/m2정맥적주，제1천；이립체강65 mg/m2정맥적주，제1、8천；순박조：순박25 mg/m2정맥적주，제2、3、4천；이립체강65 mg/m2정맥적주，제1、8천；량조균21 d위1주기，화료2주기이상자평개료효，대량조환자근기료효급독부작용진행비교，병수방질병진전시간（TTP）、생존기（OS）。결과락박조30례，총유효솔（RR）36．7％，질병공제솔（DCR）66．7％；순박조26례，RR 34．6％，DCR 65．4％，량조 RR、DCR 비교차이무통계학의의（P＞0．05）。락박조화순박조중위TTP분별위4．5개월、4．3개월，중위 OS분별위8．5개월、8．4개월，량조비교차이무통계학의의（P＞0．05）。락박조적주요독부작용위골수억제，순박조위소화도반응화골수억제。락박조혈소판감소Ⅲ～Ⅳ도교순박조명현，단차이무통계학의의（P＞0．05）；악심、구토Ⅲ～Ⅳ도발생솔순박조명현고우락박조，량조간차이유통계학의의（P＜0．05）。결론락박연합이립체강이선치료SCLC료효학절，독부작용가내수；여순박연합이립체강방안상비，료효상사，치득진일보연구관찰。
Objective To observe the effect and adverse reactions of lobaplatin or cisplatin combined with irinotecan(CPT-11)in the second line treatment of small cell lung cancer(SCLC).Methods 5 6 cases of SCLC failed in the first line treatment scheme of etoposide combined with cisplatin and progressed within 3-6 months were randomized into the lobaplatin group (lobaplatin +CPT-11)and the cisplatingroup(cisplatin+CPT-11).The lobaplatin group:lobaplatin 30 mg/m2 by intravenous drip on d 1,and CPT-11 65 mg/m2 by intravenous drip on d 1,8.The cisplatin group:cisplatin 25 mg/m2 by intravenous drip on d 2,3,4,and CPT-11 65 mg/m2 by intravenous drip on d 1,8.After more than 2 cycles of chemotherapy,the therapeutical effects were evaluated.The short term effects and the toxic and side effects were compared between the two groups.Furthermore,the time to progression (TTP)and the overall survival(OS).Results In the lobaplatin group(30 cases),the overall response rate(RR)was 36.7% with the disease control rate (DCR)of 66.7%;in the cisplatin group(26 cases),the overall RR was 34.6% with DCR of 65.4%,the difference between the two groups had no statistical significance(P>0.05).The median TTP and OS were 4.5 months and 8.5 months in the lobaplatin group,while which were 4.3 months and 8.4 months in the cisplatin group respectively,the difference in the overall RR and DCR between the two groups had no statistical significance(P>0.05)The main toxicity in the lobaplatin groups was bone marrow depression and which in the cisplatin group were the digestive tract reaction and bone marrow depression without statistical differences between the two groups(P>0.05).The occurrence rate of degreeⅢ-Ⅳ of nausea and vomiting in the cispl-atin group was significantly higher than that in the lobaplatin group with statistical difference between the two groups(P<0.05). Conclusion lobaplatin combined with CPT-1 1 as the second line treatment of SCLC has definite effect with tolerable toxicity reac-tion;compared with the scheme of cisplatin plus CPT-1 1 ,the effect is similar,which deserves to be further studied and observed.