【作者】 张楠；

【导师】 沈朋；

【作者基本信息】 浙江大学 ， 肿瘤学， 2012， 硕士

【摘要】 目的：观察伊立替康联合顺铂方案治疗小细胞肺癌的疗效和安全性,比较顺铂联合一线伊立替康(IP)二线依托泊苷(EP)治疗小细胞肺癌与一线EP二线IP的疗效。方法：伊立替康联合顺铂治疗50例经一线EP治疗或未化疗的小细胞肺癌,伊立替康60mg/m2静脉滴注,d1,8,15,DDP60mg/m2.共分3天静脉滴注,d1,2,3；每28d为1个周期。结果：总体的患者化疗缓解率RR为69.38%(局限期69.56%,广泛期69.23%)；局限期患者的中位无疾病进展生存期为7个月,广泛期患者的中位无疾病进展生存期为4个月；局限期患者的总生存期为25.1个月,广泛期患者的总生存期为13个月。主要的血液学毒性包括中性粒细胞减少和白细胞减少,3度及以上白细胞减少发生率为41.86%,3度及以上中性粒细胞减少发生率为55.81%,非血液学毒性主要为腹泻及恶心或/和呕吐,3度及以上腹泻发生率为20.93%,3度及以上恶心或/和呕吐患者发生率为18.66%。一线EP二线IP组患者的总生存期(OS)为10.0个月,一线IP二线EP组患者的总生存期(OS)为25.1个月,一线EP二线IP化疗组患者和一线P二线EP化疗组患者的OS存在显著差异(P=0.021)。3度及3度以上的血小板减少在一线EP二线IP组发生率较高,两组之间有显著性差异(P=0.01)。结论：伊立替康联合顺铂治疗小细胞肺癌疗效确切,毒副反应可以耐受。对于小细胞肺癌来说,一线IP二线EP可能较一线EP二线IP更有生存优势,毒性可以耐受,该结论需要更多样本的进一步临床研究。更多还原

【Abstract】 Objective:To evaluate the eficacy and adverse events of irinotecan(CPT-11) combined with cisplatin (DDP)in the treatment of patients with small cell lung cancer (SCLC),and compare the eficacy of regimen (first-line irinotecan/cisplatin (IP) second-line etoposide/cisplatin (EP) with regimen (first-line EP second-line IP) in the treatment of small cell lung cancer.Methods:Fifty patients with untreated or first-line EP treatment of small cell lung cancer were enrolled onto the study.。CPT-1160mg/m2was administered intravenously on days1,8, and15in combination with cisplatin60mg/m2(total) on day1,2, and3every28days.Results:The overall response rate in patients was69.38%(limited disease(LD),69.56%, extensive disease(ED)69.23%); The median response duration was7.0months for LD patients and4.0months for ED patients. The median survival was25.1 months for LD patients and13.0months for ED patients. The major grade3or4toxicities were neutropenia (55.81%), leukopenia (41.86%), diarrhea (20.93%), and nausea/vomiting (18.66%). the overall survival of first-line EP second-line IP group comparing with first-line IP second-line EP group has significant difference (10.0months vs25.1months, P=0.021). Grade3and4thrombocytopenia favored the first-line EP second-line IP group (P=0.01)Conclusion:Irinotecan plus cisplatin is an effective treatment for small-cell lung cancer., toxicity can be tolerated. For small cell lung cancer patients,the regimen of first-line IP second-line EP may be a better choice than first-line EP second-line IP.However, this conclusion requires further study with more samples.更多还原