伊立替康联合顺铂3周方案二线治疗小细胞肺癌临床观察

目的 观察伊立替康联合顺铂3周方案二线治疗复发、进展小细胞肺癌的近期疗效、生存情况及毒副反应。方法自2005年2月至2007年12月期间治疗后复发、进展小细胞肺癌患者33例。均为一线EP或EC方案治疗失败且在3个月以上出现复发或进展患者。其中男27例，女6例；中位年龄54岁；局限期13例，广泛期20例；东部肿瘤协作组体力状态（PS）评分0～1占75．8％，PS评分2占24．2％。接受伊立替康联合顺铂3周方案化疗：伊立替康80mg／m2静脉滴注第1、8天，顺铂25mg／m2静脉滴注第1～3天。21d为1个周期。每2个周期评价疗效。结果33例患者共接受103个治疗周期，中位数为3个周期。可评价病例数为33例，无完全缓解（CR）病例，部分缓解（PR）394％、稳定（SD）333％、进展fPD）27．3％、有效率39．4％、疾病控制率7217％；中位进展生存4．5个月，中位生存期9个月。骨髓抑制和迟发性腹泻为主要毒副反应，Ⅱ～Ⅳ度毒副反应发生率分别为粒细胞减少333％，血小板减少6．1％，贫血91％，延迟性腹泻9．1％，恶心、呕吐6．1％。结论伊立替康联合顺铂3周方案二线治疗小细胞肺癌有较好的疗效。毒副反应可耐受。

Three-week schedule of irinotecan plus cisplatin as second-line therapy in patients with small cell lung cancer

Objective To evaluate the efficacy and adverse effect of 3-week schedule of irinotecan plus cisplatin as second-line therapy in patients with relapsed or progressed small cell lung cancer （SCLC）. Methods Thirty-three relapsed or progressed SCLC patients treated with first-line chemotherapy （EP or EC） were enrolled in the study from February 2005 to December 2007, including 27 males and 6 females. The median age of the patients was 54y. Twenty five patients had performance status （PS） 0/1 and 8 patients had PS 2. Thirteen patients has limited disease, while the rest had extensive disease. Treatment consisted of intravenous infusion of irinotecan, 80 mg/m2 on dl and d8 followed by cisplatin infusion, 25 mg/m2 on dl ,the cycles were repeated every 3 weeks. Results Thirty-three patients received a total 103 cycles of chemotherapy with a median of 3 cycles per patients. There were 0 cases of CR, 13 cases of PR, 11 SD and 9 PD, with a ORR of 39.4% and DCR of 72.7%. The median survival time was 9 months and median time to progress was 4.5 months. The most common grade 3/4 toxicities were neutropenia （33.3%）, thrombocytopenia （6.1%）, anemia （9.1%）, diarrhea （9.1%） and nausea/emesis （6.1%）. There was no treatment-related death. Conclusion Three-week schedule of irinotecan plus cisplatin is effective in relapsed or refractory SCLC, associated with a tolerable toxicity profile.