长春瑞滨、异环磷酰胺联合顺铂治疗复合性小细胞肺癌疗效观察

目的观察长春瑞滨(NVB)、异环磷酰胺(IFO)、顺铂(PDD)三药联合治疗复合性小细胞肺癌的临床疗效及不良反应。方法 2008年3月-2010年2月,入组初治Ⅲ～Ⅳ期复合性小细胞肺癌39例,其中小细胞伴鳞癌33例,小细胞伴腺癌1例,复合性小细胞癌未分型5例;Ⅲ期17例,Ⅳ期22例。方案:NVB 25mg/m2静脉滴注,第1、8天;IF01.2mg/m2,静脉滴注,第1～3天,用药后第0、4、8小时给予美司钠解毒;DDP25mg/m2,静脉滴注,第1～3天。21d为1个周期。2周期后评价疗效,疗效及不良反应评定按照WH0标准。结果 37例患者可评价疗效,无完全缓解者,部分缓解15例,稳定18例,进展4例,总有效率为40.5%(15/37),临床受益率为89.2%(33/37)。中位疾病无进展时间为5.5个月,中位生存期为9.2个月,1年生存率为37.9%。主要不良反应为骨髓抑制及胃肠道反应,绝大多数患者耐受良好。结论 NIP方案治疗复合性小细胞肺癌有效且安全。

To observe the effect of combination chemotherapy of Navelbine,Ifosfamide and Cisplatin in the treatment of combined small cell lung cancer

Objective To observe the effect and adverse reaction of combination chemotherapy of Navelbine （NVB） , Ifosfamide （IFO） and Cisplatin （PDD） in the treatment of combined small cell lung cancer （SCLC） . Methods 39 patients diagnosed as staged Ⅲ to Ⅳ combined small cell lung cancer in our hospital from Mar 2008 to Feb 2010 were enrolled,including 33 SCLC with squamous cell carcinoma,1 with adenocarcinoma and 5 with unclear histological classification. The stages distribution included 17 Ⅲ and 22 Ⅳ. The chemotherapy regimen consisted of NVB 25mg/m2 on days 1 and 8,IFO 1. 2mg/m2 and PDD 25 mg/m2 on days 1 ～ 3 every 21 days. The effect and adverse reaction were evaluated according to standard of WHO. Results In the 37 patients,there were no complete responses,15 partial responses,18 stable diseases,and 4 progressive diseases. Overall response rate was 40. 5% （15/37） ,and the median time to disease progression was 5. 5 months and the median survival was 9. 2 months,one year survival was 37. 9% . The chief adverse reactions were marrow refrain and gastrointestinal effect. Conclusion NIP is active and safe in the treatment of combined SCLC.