【摘要】 目的:观察拓扑替康的血液毒性反应,评价拓扑替康在临床应用的安全性。方法:113例初次接受3个周期化疗的非小细胞肺癌患者分为三组,TP组53例(拓扑替康0.75mg/m2,顺铂20mg/m2,第1～5天);NP组30例(去甲长春花碱25mg/m2,第1,8天,顺铂20mg/m2,第1～5天);HP组30例(羟基喜树碱6mg/m2,顺铂20mg/m2,第1～5天);21天为1个周期。第3周期末评价血液毒性。结果:化疗有效率TP组39.62%,NP组33.33%,HP组30.00%,组间比较无显著性差异(P>0.05);三组血液毒性反应中,TP组白细胞Ⅲ级下降18例,Ⅳ级15例,Ⅲ～Ⅳ级下降占62.26%,白细胞Ⅲ～Ⅳ级下降与NP和HP组比较均有显著性差异(P<0.05);TP组血小板Ⅲ级下降15例,Ⅳ级下降13例,Ⅲ～Ⅳ级下降占52.83%。血小板Ⅲ～Ⅳ级下降反应与NP组和HP组比较也有显著性差异(P<0.05)。结论:拓扑替康具有较重的血液毒性反应,尤其是Ⅲ～Ⅳ级反应,以白细胞和血小板下降为主。临床应用期间应注意血象监测,适时采取措施,即使发生Ⅲ～Ⅳ级骨髓抑制反应,对患者也是安全的。更多还原

【Abstract】 Objective:To investigate the blood toxicity of topotecan and evaluate its safety in clinical practice.Method:113cases with non-small cell lung cancer were divided into three treatment groups:53cases in TP group(topotecan0.75mg per m 2 body-surface and cisplatin20mg per m 2 on days1to5),30cases in NP group(vinorelbine25mg per m 2 on day1and day8,and cisplatin20mg per m 2 on days1to5),30cases in HP group(hydroxycamptothecine6mg per m 2 and cisplatin20mg per m 2 on days1to5).3courses(a course of21days)were given,then the blood toxicity was assessed.Results:The efficacy rate of TP group was39.62%,NP group33.33%and HP group30.00%,with no significant differences between them(P>0.05).As for blood toxicity in TP group,third degree and fourth degree leucopenia occured in18and15cases respectively,accounting for62.26%,and third degree and four th degree thrombocytopenia in15and13cas-es respectively,accounting for52.83%.Compared with NP and HP groups,both leucopenia and thrombocytopenia in TP group showed significant differences(P<0.05).Conclusion:Blood counts should be made frequently because white blood cells and platelets would be seriously affected by topotecan,resulting in leucopenia and thrombocytopenia.更多还原