奈达铂＋依托泊苷同步放疗治疗局限期小细胞肺癌的疗效观察

目的：探讨奈达铂＋依托泊苷联合同步放疗治疗局限期小细胞肺癌的临床疗效.方法：选取61例局限期小细胞肺癌患者随机分为治疗组（奈达铂＋依托泊苷联合放疗）和对照组（顺铂＋依托泊苷联合放疗）.对照组30例采用依托泊苷75mg/m2,静滴d1-5,顺铂80mg/m2,静滴d1.21天为1周期.化疗第一天开始实施放疗.放疗采用等中心放疗（SAD）,6MV-X线,常规照射2Gy/（f·d）,总剂量50Gy/（25f·5w）.连续化疗共6个周期.治疗组31例奈达铂替代顺铂80mg/m2,其余均同对照组.两组中治疗达完全缓解（CR）的患者行脑预防性照射（PCI）.结果：全部病例随访时间≥24个月,随访率为98.4％.两组有效率及1、2年生存率分别为83.9％、83.9％、61.3％和83.3％、80.0％、56.7％,无显著性差异（P＞0.05）.但治疗组在胃肠道反应及肾功能损伤等毒副反应方面有显著性优势.治疗组胃肠道反应发生率为64.5％,而对照组为90.0％,差异有统计学意义（P＜0.05）.治疗组肾功能损伤为6.5％,而对照组为30.0％,差异亦有统计学意义（P＜0.05）.结论：奈达铂＋依托泊苷联合同步放疗治疗局限期小细胞肺癌疗效确切,且胃肠道及肾脏毒性小,提高了患者对放化疗的耐受性,值得临床推广.

Efficacy of nedaplatin and etoposide with concurrent radiotherapy in limited-stage small cell lung cancer

Objective：To evaluate the clinical efficacy of NDP ＋ VP-16 with current radiatherapy for the patients of limited small cell lung cancer.Methods：All 61 patients were enrolled and divided into two groups at random.Patients in control group were treated by DDP （80mg/m2,d1） ＋ VP-16 （75mg/m2,d1-5） with current radiatherapy while in treatment group were treated with NDP（80mg/m2,d1）instead of DDP,continuity 6 cycles,21 days as 1 cycle.Two groups were accepted breast radiotherapy on the first day of chemotherapy and reach to DT =50Gy.Results：The total efficacy was 83.9％ in treatment group and 83.3％ in control group（P ＞ 0.05）.The survival rates of 1 year、2 years in treatment group were 83.9％ and 61.3％,the control group 80.0％ and 56.7％ （P ＞ 0.05）.The adverse effect of gastrointestine and renal dysfunction was significant lower in treatment group（64.5％,6.5％） than the control （90.0％,30.0％）,the difference was significant （P ＜ 0.05）.Conclusion：The efficacy of NDP ＋ VP-16 combined with radiation therapy is effective in the limited small cell lung cancer,with tolerable toxicities.