伊立替康联合顺铂治疗晚期非小细胞肺癌临床报告

目的评价伊立替康（CPT-11）联合顺铂（DDP）方案治疗晚期非小细胞肺癌（NSCLC）的疗效和不良反应。方法由国内4家医院协作研究完成。入组晚期NSCLC患者36例中,初次化疗24例,曾经化疗12例;全部患者均有可测量或可评价的指标。给药方法：CPT-1160mg／m^2静脉滴注,第1、8、15天;DDP80mg／m^2静脉滴注,第1天;28d为1个周期。结果36例患者共接受治疗97个周期,中位数为3个周期。可评价病例数为35例,无CR病例,PR8例（22．9％）,SD21例（60．0％）,PD6例（17．1％）。初治者有效率为29．2％（7／24）,复治者有效率为9．1％（1／11）,中位治疗至进展时间为199d,1年生存率为45．4％。Ⅲ、Ⅳ度不良反应发生率为粒细胞减少（16．7％）,脱发（13．9％）,腹泻（5．6％）,恶心呕吐（2．8％）。结论CPT-11联合DDP方案对晚期NSCLC治疗有效,患者耐受性良好,应进行深入研究。

Irinotecan plus cisplatin for the treatment of advanced non-small cell lung cancer

OBJECTIVE: To evaluate the efficacy and adverse events of irinotecan (CPT-11) combined with cisplatin (DDP) in the treatment of patients with advanced non-small cell lung cancer (NSCLC). METHODS: Of 36 NSCLC patients consisting of 23 males and 13 females with a medium age of 52 years included, there were 26 adenocarcinomas, 7 squamous cell carcinomas, 1 adeno-squamous cell carcinoma and 2 unclassified types; 13 stage III B and 23 stage IV; 24 chemonaive and 12 previously treated by chemotherapy with a medium Karnofsky status of 90. All patients had measurable or evaluable parameters. The regimen was administered as following: CPT-11 60 mg/m2, IV, D1, 8 and 15; DDP 80 mg/m2, IV, D1; every 28 days as a cycle. RESULTS: Totally, 97 cycles were carried out in these 36 patients with a medium cycles of 3. Of 35 evaluable patients, 22.9% (8/35) achieved partial response, 60.0% (21/35) had stable disease and 17.1% (6/35) progressive disease. The response rate was 29.2% (7/24) for chemonaive patients and 9.1% (1/11) for these previously treated. The 1-year survival rate was 45.4% with a medium time to tumor progression (TTP) of 199 days for the responders. The incidence rate of grade III/IV adverse events were: 16.7% for neutropenia, 13.9% alopecia, 5.6% diarrhea, 2.8% nausea and vomiting, respectively. CONCLUSION: Irinotecan plus cisplatin is effective with tolerable adverse events in treating patients with advanced non-small cell lung cancer, but further investigation trials are needed.