拓扑替康联合顺铂方案与IEP方案治疗复发性小细胞肺癌的疗效比较

目的：比较拓扑替康联合顺铂方案与IEP方案治疗复发性小细胞肺癌的疗效和不良反应。方法：80例复发性小细胞肺癌中,37例应用拓扑替康-DDP方案（拓扑替康0.75mg/m2,第1-5天静点,DDP25mg/m2,第1-3天静点）;43例应用IEP方案（IFO1.2mg/m2,第1-3天静点,Mesna400mg静注,第0、4、8小时,第1-3天,VP-16100mg,第1-5天静点,DDP25mg/m2,第1-3天静点）。两组的治疗周期为21天,完成2周期后评价疗效及不良反应。结果：拓扑替康组有效率为45.9%（17/37）,IEP组有效率44.2%（19/43）,两组疗效无差异（P〉0.05）,两组不良反应主要表现为：骨髓抑制,白细胞下降IEP方案高于TP方案（55.8%和45.9%）,但两组无显著性差异（P〉0.05）;血小板下降IEP方案高于TP方案（30.2%和13.5%）,两组有显著性差异（P〈0.05）;脱发IEP方案高于TP方案（76.7%和5.4%）,两组有显著性差异（P〈0.01）。结论：拓扑替康联合顺铂方案与IEP方案治疗复发性小细胞肺癌均取得较好疗效,TP方案不良反应较IEP方案轻,两方案不良反应均可以耐受。

Treatment effects of TP and IEP regimen on recurrent small cell lung cancer

Objective： To compare the efficacy and toxicity between TP（ Topotecan＋cisplatin）regimen and IEP（ifosfamide＋etoposide＋ cisplatin）regimen in the second-line treatment of recurrent small cell lung cancer （SCLC）. Methods： Total of 80 cases of recurrent small cell lung cancer were enrolled.37 cases were treated with TP regiment （Topotecan 0.75mg/m2 iv gtt d1-5,DDP 25mg/m2 iv gtt d1-3）;43 cases were treated with IEP regiment,（IFO 1.2mg/m2 iv gtt d1-3,mesna 400mg iv 0,4,8h,d1-3,VP-16 100mg iv gtt d1-5,DDP 25mg/m2 iv gtt d1-3）. Results： For the cases treated with TP regimen,the overall response rate was 45.9%（17/37）,for the cases with IEP regimen,the overall response rate was 44.2%（19/43）（P0.05）.Major toxicity was myelosuppression.The leucocytopenia for IEP regimen was higher than TP regimen（55.8% versus 45.9%）（P0.05）, thrombocytopenia for IEP regimen was higher than TP regimen（30.2% versus 13.5%）（P0.05）,alopecia for IEP regimen was higher than TP regimen（76.7% versus 5.4%）（P0.01）. Conclusion： TP and IEP regimen in the second-line treatment of recurrent small cell lung cancer have good chinical efficacy and tolerability. The side-effects of TP regimen are less than IEP regimen in recurrent SCLC.