HEP方案程序性给药治疗耐药性肺癌探讨

目的：寻找治疗耐药肺癌的化疗方法，研究程序依赖性给药逆转耐药的作用。方法：有细胞学或病理学诊断依据，经MVP（丝裂霉素+长春花碱酰胺+顺铂）或AVP（阿霉素+长春花碱酰胺+顺铂）方案化疗≥2次，病情仍进展的耐药肺病患者，随机分组，观察组按时间顺序应用羟基喜树碱、鬼臼乙叉甙及顺铂治疗耐药性肺癌。对照组常规应用羟基喜树碱、鬼臼乙叉甙及顺钳治疗耐药性肺癌。结果：该方案能使耐药肺癌重获疗效，对鳞癌有效率观察组38％，对照组22％；对腺癌有效率观察组50％，对照组0％；对SCLC有效率观察组50％，对照组50％。结论：程序性给予羟基喜树碱、鬼臼乙叉甙及顺铂（HEP方案）治疗耐药性肺癌能提高疗效，克服DNA拓朴异构酶（Topo）Ⅱ活性降低导致的多药耐药。

Discussion for Programmed Use of HEP Plan to Treat Drug-resistant Lung Cancer

To find a chemotherapy method to treat drug - resistant lung cancer and study the reverse action of pro-grammed use to drug - resistant. Methods: The drugresistant oatients whose condition were stioll progressive after twice treat-ments of MVP or AVP chemotherapy according to cytological and pathological diagnosis were divided into observation groupand control group.The HCPT,VP16and DDP were given in time order in observation group and routiely in control group.Result:This plan could make the drug - resistant patients get curative effect again.The effective rate of squamous carcinomain observation group and control group were 38% and 22%; in adenoma were 50% and 0; in SCLC 50% and 50%. Con-clusion:The programmed use of HCPT, VP16 and DDP to treat drug - resistant patients could increase the effective rate andovercome the multi - drug resistance caused by low activity of DNA topoisomerase Ⅱ.