洛铂联合伊立替康治疗复治性小细胞肺癌的临床研究

目的　观察洛铂联合伊立替康方案治疗经ＥＰ方案初治后３～６个月内复发的广泛期晚期小细胞肺癌（ＳＣＬＣ）的疗效和安全性。方法　选取２４例ＳＣＬＣ患者予洛铂３５ｍｇ／ｍ^２，ｄ_１；伊立替康２００ｍｇ／ｍ^２，ｄ_１，２１ｄ为１周期。２个周期后评价疗效和毒副反应，并随访总生存时间（ＯＳ）和疾病进展时间（ＴＴＰ）。结果　２４例均可评价疗效，完全缓解２例，部分缓解８例，总有效率为４１.７％；稳定５例，进展９例，中位ＴＴＰ为４.３个月，中位ＯＳ为７.４个月。毒副反应主要为血液学毒性和消化道反应，３、４级白细胞减少、中性粒细胞减少和血小板减少发生率分别为５０.０％（１２／２４）、４１.７％（１０／２４）和２０.８％（５／２４）；腹泻发生率为８７.５％（２１／２４），其中３、４级腹泻为５８.３％（１４／２４）。全组无毒性相关死亡。结论　洛铂联合伊立替康方案作为中度敏感复发性ＳＣＬＣ的挽救治疗方案有较好的疗效，毒副反应可以耐受。

Clinical observation of combined chemotherapy of lobaplatin and irinotecan in the treatment of relapsed advanced small cell lung cancer

Objective To observe the efficacy and safety of chemotherapy consisted of lobaplatin and irinotecan for Chinese patients with advanced small cell lung cancer（SCLC）. Methods Eligible patients with SCLC who had relapsed in 3-6 months after the first line therapeutic regimen of EP were done with lobaplatin and irinotecan. The regimen consisted of lobaplatin 35mg/m^2 on d1 and irinotecan 200mg/m^2 on dl, the plan was given every 21 days. Results Twenty-four patients were evaluable for response, in which 2 achieved complete response and 8 partial responses, namely the objective responses rate was 41.7%, 5 patients had stable disease and 9 progressive diseases. Thus the disease control rate was 62. 5%. The median time to progression and overall survival was 4. 3 months and 7.4 months, respectively. The main toxicity was the matological toxicity and gastrointestinal tract side reaction. Grade Ⅲ, Ⅳ- leucopenia was seen in 12 patients（50. 0% ）, neutropenia in 10 patients（41.7% ）, and thrombocytopenia in 5 patients（20. 8% ）. Diarrhea was seen in 21 patients（87.5% ）, 14 of who were grade Ⅲ,Ⅳ. There was no treatment-related death. Conclusion The combination of lobaplatin and irinotecan is highly active and tolerable in patients with chemotherapy mediate sensitive relapsed SCLC when it is administered as rescue treatment.