盐酸拓扑替康治疗小细胞肺癌临床研究

目的探讨盐酸拓扑替康(TPT)在治疗小细胞肺癌中的临床疗效和不良反应.方法 36例小细胞肺癌患者接受TPT治疗.分二组.A组32例,TPT 1.2mg/m2,静脉滴注30min,连用5d(第1～5天),21d为1周期,连用2周期;B组4例,TPT用法同前,联合顺铂60mg/m2,第1天静脉滴注,水化3d,21d为1周期,连用2周期.结果可评价疗效30例,其中A组26例,B组4例.总有效率A组46.2%,B组25.0%.中位生存期A组48.2周,B组26周.1年生存率A组初治58.8%,复治42.8%(B组例数少无法评价).可评价不良反应36例,主要有骨髓抑制(Ⅲ、Ⅳ度中性粒细胞下降,血小板降低)、恶心、呕吐、腹泻、脱发、乏力等,对心、肝、肾功能均无影响.结论 TPT是对小细胞肺癌有较好治疗作用的药物,剂量限制性毒性为骨髓抑制.前景为继续探讨在小细胞肺癌治疗中适宜的剂量和联合使用其他抗肿瘤药物的有效剂量,并进一步减轻不良反应;探讨TPT在非小细胞肺癌中的治疗作用、适宜的剂量、疗效及不良反应.

Study on topotecan in the treatment of small-cell lung cancer

Objective To explore the efficacy and safety of topotecan in the treatment of small cell lung cancer (SCLC).Methods A total 36 patients with SCLC were enrolled this study.32 cases (A group) were treated with single topotecan in the dose of 1.2mg/m 2 administered on day 1 to 5 of 21 day cycle upto 2 cycles,4 cases (B group) were treated with topotecan in the same dose combined with cisplatin in the dose of 60mg/m 2 administered on day 1 (3 days hydrotherapy) of 21 day cycle upto 2 cycles.Results The total effective rate (TER) was 46.2% in A grooup and 25% in B group.The median survival time was 48.2 weeks in A group and 26 weeks in B group.The one year survival rate was 58.8% (first therapy) and 42.8% (repeat therapy) in A group,it could not be evaluated in B group because of little case.Among 36 patierts,main side effects were as following:myelosuppressive?nosea?vomitting?diarrhea?alopecia and fatigue etc,but no damage to liver and renal function.Conclusions Topotecan appeared to be a better agent with a certain efficacy and acceptable side effect,dose limiting toxicity was myelosuppressive.It is necessary furthermore to explore the suitabe dosage of topotecan,its effective action and toxicity,especially its ambination with other anti tumor drugs in the treatment of NSCLC.