【摘要】 目的:评价洛铂联合依托泊苷治疗初治小细胞肺癌的疗效和毒副反应,并与同期应用的顺铂联合依托泊苷治疗初治小细胞肺癌的方案相比较。方法:回顾性分析2006年5月至2008年10月浙江省肿瘤医院住院治疗的42例初治小细胞肺癌患者,局限期23例,广泛期19例,其中洛铂治疗组23例:洛铂30mg/m~2,iv,d1,依托泊苷100mg/m~2,iv,d1～3;顺铂治疗组19例:顺铂25mg/m~2,iv,d1～3,依托泊苷剂量及用法同上。并对两组患者近期疗效、疾病进展时间、1年生存率及毒副反应进行比较。结果:洛铂组CR 8例,PR 8例,SD 4例,PD 3例;顺铂组CR 8例,PR 7例,SD 2例,PD 2例;两组总有效率(ORR)分别为69.6%和78.9%,差异无统计学意义(P=0.726);两组中位疾病进展时间分别为8个月和10个月(P=0.553),1年生存率分别为66.6%和64.3%(P=0.973),均无统计学差异。全组主要毒性反应为骨髓抑制和恶心/呕吐。洛铂组Ⅲ～Ⅳ度血小板减少较顺铂组明显,但统计学无明显差异(P=0.239),顺铂组Ⅲ～Ⅳ度恶心/呕吐发生率明显高于洛铂组(P=0.043)。结论:洛铂联合依托泊苷治疗初治小细胞肺癌疗效确切,毒副反应可耐受;与顺铂联合依托泊苷方案相比,疗效相似,值得临床进一步研究。更多还原

【Abstract】 Objective: To compare the efficacy and adverse effects of a regimen of etoposide and cisplatin with those of etoposide and Iobaplatin in treating small-cell lung cancer. Methods: Data from 42 patients with small-cell lung cancer who received initial treatment in our hospital during the period between May 2006 and October 2008 were retrospectively analyzed. Of these patients, 23 were at the limited-stage disease and 19 at the extensive-stage disease. Twenty-three of the total patients were assigned to the Lobaplatin Group: Lobaplatin was given at 30 mg/m~2 i.v on day 1, etoposide was given at 100mg/m~2 i.v from day 1 to day 3. The remaining 19 patients were assigned to the Cisplatin Group: Cisplatin was given at 25mg/m~2 and etoposide was given at 100mg/m~2 i.v from day 1 to day 3. The dosage and usage of etoposide were the same in the 2 groups. Comparisons were conducted for efficacy, time to progression of disease (PD), 1-year survival rate, and adverse effects between the patients of the two groups. Results: All 42 patients were evaluated for curative effect. In the Iobaplatin group, complete remission (CR) was observed in 8 of the cases, partial remission (PR) was observed in 8, stable disease (SD) was observed in 4 and PD was observed in 3. In the cisplatin group, CR was seen in 8 of the cases, PR was seen in 7, SD was seen in 2 and PD was seen in 2. The overall response rate (ORR) was 69.6% in the Iobaplatin group and 78.9% in the cisplatin group. There was no statistical difference in the response rate between the two groups (P= 0.726). The median time to PD was 8 months for the Iobaplatin group and 10 months for the cisplatin group (P=0.553), and the one-year survival rates were 66.6% and 64.3% (P=0.973), respectively. There were no statistical differences in the time to PD or one-year survival rate. The main adverse reaction included bone-marrow depression and nausea/vomiting. The incidence of grade-Ⅲ～Ⅳ thrombocytopenia was higher in the Iobaplatin group than in the cisplatin group (P=0.239), without statistically significant differences between the two groups. The incidence of nausea/vomiting was higher in the cisplatin group than in the Iobaplatin group (P=0.043). Conclusion: The etoposide plus Iobaplatin regimen is an effective and low-toxicity chemotherapy in initial treatment of small-cell lung cancer. The curative effects of the two regimens are similar, warranting further clinical research.更多还原