原发性肺癌含洛铂双药化疗同步放疗疗效及安全性研究

目的第3代铂类药物洛铂(lobaplatin,LBP),相较于顺铂(cisplatin,DDP)和卡铂(carboplatin,CBP)不良反应发生率较低,且疗效基本与2代持平,但在肺癌同步放化疗中还缺乏相应治疗数据。本研究分析含LBP双药化疗联合同步放疗对原发性肺癌的疗效及安全性,并与含DDP或CBP方案对比,初步评价LBP联合同步放疗治疗肺癌的可行性。方法回顾性分析天津医科大学肿瘤医院放疗科2011-11-01-2017-06-30收治的70例原发性肺癌患者病例资料,均采用以铂类为基础的双药方案化疗。依据铂类不同分为LBP组(LBP+依托泊苷/培美曲塞/多西他赛)和CBP/DDP组(CBP/DDP+依托泊苷/培美曲塞/多西他赛)。治疗过程中严密观察患者不良反应,结束治疗后1个月复查胸部CT评价疗效。采用Mann-Whitney U秩和检验或χ2检验分析疗效及不良反应差异。结果接受相同化疗方案的LBP组和CBP/DDP组患者近期疗效评价基本一致,LBP组和CBP/DDP组全组CR分别为20.0%(7/35)和22.9%(8/35),PR分别为48.6%(17/35)和45.7%(16/35),2组SD与CR相同,PD分别为11.4%(4/35)和8.5%(3/35)。LBP组白细胞减少总发生率为57.1%(20/35),低于CBP/DDP组的85.7%(30/35),χ2=7.000,P=0.016;其余不良反应2组差异无统计学意义,P>0.05。结论与CBP和DDP等经典铂类化疗药相比,含LBP双药化疗联合同步放疗治疗肺癌效果相当,且安全性较高,在CBP/DDP发生耐药后可推荐作为一线替代用药。

Adverse reactions of concurrent chemoradiation for primary lung cancer treated with lobaplatin regimen

OBJECTIVE The third-generation platinum drug,lobaplatin,has a lower incidence of adverse reactions than cisplatin and carboplatin,and its efficacy is basically the same as that of the second generation.However,there is still no corresponding treatment data in concurrent chemoradiotherapy for lung cancer.We evaluated the clinical efficacy and safety of lobaplatin-based versus carboplatin/cisplatin-based concurrent chemoradiotherapy for primary lung cancer.METHODS A total number of 70 patients with lung cancer treated in Department of Radiotherapy of Tianjin Medical University Cancer Hospital from November 1,2011 to June 30,2017 were retrospectively included in this study.According to the chemotherapy regimen,35 patients were assigned to lobaplatin group(combined with etoposide/pemetrexed/docetaxel)and 35 patients were assigned cisplatin/carboplatin group(combined with etoposide/pemetrexed/docetaxel).Throughout the treatment,adverse reaction were closely observed one month after treatment,chest computed tomography was performed to evaluate the short-term treatment outcomes.The Mann-Whitney Urank sum test or χ2 test was used to analyze the difference in efficacy and adverse reactions between the two groups.RESULTS The lobaplatin group and cisplatin/carboplatin group almost had a same clinical effect combined with different chemicals.The complete response rates of lobaplatin group and cisplatin/carboplatin group were 20.0%(7/35)and 22.9%(8/35),and the partial response rates were 48.6%(17/35)and 45.7%(16/35),respectively.The stable disease rates were the same with complete response rates in the two groups.The progressive disease rates were 11.4%(14/35)and 8.5%(3/35).The total incidence of leukopenia in lobaplatin group was 57.1%(20/35),lower than that in cisplatin/carboplatin group(85.7%,30/35)(χ2=7.000,P=0.016),but there was no significant differences in other adverse reactions between the two groups.CONCLUSION Compared with classical platinum chemotherapeutic drugs such as cisplatin and carboplatin,the lobaplatin has good security and adverse reactions were less happened.