奈达铂顺铂联合依托泊苷治疗小细胞肺癌的临床研究

  目的  评价奈达铂联合依托泊苷治疗初治小细胞肺癌的疗效和毒副反应, 并与同期应用的顺铂联合依托泊苷治疗初治小细胞肺癌的方案相比较。   方法   收集2009年5月至2011年11月间三峡大学第三临床医学院葛洲坝中心医院住院治疗的42例初治小细胞肺癌患者, 采用单双数随机分组, 治疗组21例: 奈达铂80 mg/m2iv d1, 依托泊苷100 mg/m2d1~3;对照组21例: 顺铂80 mg/m2计算总量后平均分配为连续3天静滴, 联合水化利尿, 依托泊苷100 mg/m2iv d1~3。并对两组患者的近期疗效、无进展生存期、1年生存率及毒副反应进行比较。   结果   治疗组与对照组总有效率(ORR)分别为73.7%vs.72.2%, 差异无统计学意义(P > 0.05);中位无进展生存期分别为7.6个月和9.3个月, 1年生存率分别为64.5%和61.7%, 差异均无统计学意义(P > 0.05)。两组的主要毒副反应为骨髓抑制和胃肠道反应, 白细胞下降的发生率分别为66.7%和61.9%, 无显著性差异(P > 0.05);血小板减少治疗组较对照组发生率高, 有显著性差异(42.9%vs.23.8%, P < 0.05);恶心、呕吐的发生率治疗组明显低于对照组(P < 0.05)。   结论  奈达铂联合依托泊苷治疗初治SCLC近期疗效确切, 毒副反应可耐受, 取得顺铂联合依托泊苷方案类似的效果, 在某些毒副反应方面有一定的优势。 

Nadaplatinum Cisplatin with Nucleoside Treatment of Small-Cell Lung Cancer:A Clinical Research

  Objective  To compare the therapeutic efficacy and the adverse effects of a regimen with etoposide and cisplatin and a therapy of etoposide and nadaplatin in treating small-cell lung cancer (SCLC).   Methods  Data from May 2009 to November 2011 of 42 SCLC patients receiving initial treatment were collected. All participants in this study were admitted in The Third School of Clinical Medicine and Gezhouba Central Hospital, Three Gorges University, Yichang. The cases were randomly grouped based on odd and even numbers. The doses administered to 21 cases (G1) for the treatment group were as follows: 80 mg/m2 nedaplatin, iv dl and 100 mg/m2 etoposide, dl. In the control group composed of another 21 cases (G2), after calculating the volume dose of 80 mg/m2 cisplatin, an average distribution of the intravenous drip was given for three consecutive days, with hydration diuresis and 100 mg/m2 etoposide iv gtt dl-d3. Among the patients in the two groups, a comparison was conducted on the short-term curative effect, progression-free survival, one-year survival rate, and untoward effects.   Results   The overall response rate was 74.2% and 72.2% in G1 and G2, respectively. No statistical significance was observed between the two groups (P > 0.05). The median of the progression-free survival rate was 7.6 and 9.3 months, whereas the one-year survival rate was 64.5% and 61.7% in G1 and G2, respectively. No significant differences were observed between the two groups (P > 0.05). The main toxic effects observed among the groups were bone marrow inhibition and gastrointestinal reaction, where the incidence rate for the decrease of white blood cells was 66.7% and 61.1%, respectively, without significant difference (P > 0.05). The incidence rate of thrombocytopenia was higher in G1 than in G2, with significant differences (42.9% vs. 27.8%, P < 0.05). In addition, the incidence rate of nausea and vomiting was significantly lower in G 1 than in G2 (P < 0.05).   Conclusion  The regimen of Nadaplatinum joint with etoposidein initially treating SCLC patients has a definite short-term effect. The adverse reaction is tolerable during the treatment, whereas thetherapeutic efficacy is similar to the scheme of cisplatin combined with etoposide with predominance in restraining adverse reactions to someextent.