洛铂联合足叶乙甙或伊立替康治疗广泛期小细胞肺癌的临床观察

目的 观察洛铂联合足叶乙甙或伊立替康治疗广泛期小细胞肺癌（SCLC）的疗效和安全性。方法 收集经病理组织学确诊的初治或复治广泛期SCLC患者45例，其中接受LE方案（洛铂30mg／m²静滴，d₁；足叶乙甙 100mg／m²静滴，d₁～d₃，21天为1周期）25例，LI方案（洛铂30mg／m²静滴，d₁；伊立替康60mg／m²静滴，d₁、d₈、d₁₅，28天为1周期）20例。至少化疗2个周期后评价客观疗效和毒副反应。结果 45例患者均可评价疗效，获CR 2例，PR 24例，SD 15例，PD 4例，有效率（RR） 为57.8％。LE组的RR为48.0％（12／25），LI组的RR为70.0％（14／20），两组差异无统计学意义（P＞0.05）。LE组和LI组的中位总生存期分别为8.0个月和7.0个月。全组毒副反应主要为血液学毒性和胃肠道反应，其中3～4级血小板减少发生率为17.8％（8／45），LI组较LE组高（30.0％ vs. 8.0％，P=0.002）。全组3～4级腹泻发生率为8.9％（4／45），均发生于LI组且为复治患者。无治疗相关性死亡。结论 洛铂联合足叶乙甙或伊立替康治疗晚期SCLC疗效较好，毒副反应均可耐受，值得临床进一步研究。

Clinical observation of lobaplatin combined etoposide or irinotecan for advanced small cell lung cancer

Objective To observe the efficacy and safety of lobaplatin（LBP） combined with etoposide or irinotecan for pa- tients with advanced small cell lung cancer（SCLC）. Methods Forty-five patients with histologically diagnosed SCLC were divided in- to two groups. The LE regimen group（ lobaplatin 30mg/m2 iv d1 , VP-16 100rag iv d1-d3 ,21 days were a cycle） had 25 patients and the LI regimen group（ lobaplatin 30mg/m2 iv dj , irinotecan 60 mg/m2 iv d1 ,ds ,dis ,28 days were a cycle） had 20 patients. The efficacy and toxicity were evaluated after at least two cycles of chemotherapy. Results Forty-five patients were evaluable for response, in which 2 achieved complete response（ CR）, 24 partial responses（ PR）, and the response rate（RR） was 57. 8%. The RR in LE regi- men group was 48.0% （ 12/25 ）, while in LI regimen group was 70. 0% （ 14/20）. The median overall survival（OS） of LE regimen and LI regimen were 8.0 months and 7.0 months, respectively（ P = 0. 255 ）. The main toxicities were reversible bone marrow suppression and gastrointestinal reaction. Grade 3-4 thrombocytopenia rate was 17. 8% （8/45） , the oceurenee rate was higher in LI regimen than LE regimen（30. 0% vs. 8.0%, P =0. 002）. All grade 3-4 diarrhea was all occurred in patients with LI regimen（8. 9% ,4/45）, who were retreated patints too. There was no treatment-related death. Conclusion Lobaplatin combined with etoposide or irinotecan is ef- fective and tolerated for patients with advanced small cell lung cancer, and worth further study.