伊立替康单药与伊立替康联合顺铂二线治疗小细胞肺癌的临床比较

目的比较伊立替康（CPT-11）单药或合用顺铂（DDP）二线治疗小细胞肺癌（SCLC）的临床疗效和毒副反应。方法将58例复治SCLC患者随机分为单药组和联合化疗组。单药组30例,采用CPT-11 60 mg/m2静脉输注,第1、8、15天;联合化疗组28例,采用CPT-11 60 mg/m2静脉输注,第1、8、15天,加DDP 25 mg/m2静脉输注,第1～3天。均28天为1周期,每例至少完成2周期化疗。结果单药组有效率33.3%,联合化疗组有效率35.7%,相互比较差异无显著性（P〉0.05）。毒副反应联合化疗组明显高于单药组（P〈0.05）,主要表现为Ⅲ～Ⅳ度骨髓抑制和恶心呕吐,尤其是血小板减少。结论CPT-11单药与CPT-11联合DDP二线治疗SCLC疗效相同,但联合化疗的毒副反应明显高于单药化疗,因此推荐单药化疗。

Clinical comparison between single agent of irinotecan and combination of irinotecan and cispaltin in second-line treatment of small cell lung cancer

Objective To compare the clinical efficacy and adverse reactions of single medication of irinotecan （ CPT - 11 ） and CPT - 11 plus cisplatin in second - line treatment of small cell lung cancer （SCLC）. Methods 58 patients with relapsed SCLC were divided into single -agent group （30 patients） and combined group （28 patients）. Those in single- agent group were given CPT- 11 60 mg/m^2 on the 1st day, 8th day and 15th day; and those in the combined group received CPT- 11 60mg/m^2 on the 1st day, 8th day and 15th day, coupled with addition of cisplatin 25 mg/m^2 from the 1st to 3rd day, all by intravenous dripping. A chemotherapeutic cycle of 28 days was repeated at least once in each case. Results The response rate of single - agent group was 33.3%, and that of the combined group was 35.7%, with insignificant difference （ P 〉 0.05 ）. The combined group had greater adverse reactions （ P 〈 0.05 ）, which mainly included Ⅲ ＋ Ⅳ degree bone marrow depression, nausea and vomiting, especially thrombocytopenia. Conclusion Single administration of irinotecan has the same effect as its combination with cisplatin in second - line treatment of SCLC. However, owing to its less toxicity and adverse reactions, CPT - 11 alone is recommended in the chemotherapy for SCLC.