替莫唑胺治疗老年广泛期小细胞肺癌疗效观察

目的:观察对于60~85岁老年广泛期小细胞肺癌（small cell lung cancer,SCLC）患者给予一线化疗药物治疗后6月内复发后二线化疗药物临床疗效及耐受性。方法:选取2013年1月至2017年1月间在研究中心就诊的经过EP方案一线治疗后6月内复发的老年广泛期小细胞肺癌患者44例，分为替莫唑胺组（n=22）和对照组（n=22）。替莫唑胺组给予替莫唑胺每天150 mg/m2，连续服用5天，28天为一周期。对照组给予伊立替康65 mg/m2，d1、8+顺铂75 mg/m2分3天，d2~4,静脉输注。2周期复查评价治疗效果。对比两组有效率、疾病控制率、无进展生存期及不良反应发生率。结果:替莫唑胺组与对照组的有效率、疾病控制率分别为18％ vs 18％、23％ vs 27％，差异无统计学意义（P＞0.05）；替莫唑胺组与对照组的无进展生存时间分别为5.3个月和5.5个月，差异无统计学意义（P＞0．05）；替莫唑胺组的胃肠道反应、腹泻及骨髓抑制明显低于对照组，差异有统计学意义（P＜0．05）。结论:替莫唑胺口服28天一周期方案化疗有效率高，老年患者耐受性好，是经一线治疗后6月内复发的老年广泛期小细胞肺癌患者值得选择的化疗方案。

The efficacy of temozolomide capsule in the treatment of extensive small cell lung cancer in the elderly patients

Objective:To evaluate the efficacy and toxicity of temozolomide capsule used for patients who had relapsed after first-line chemotherapy drugs within 6 months of extensive small cell lung cancer in the elderly patients,whose age was from 60 to 85 years.Methods:44 elderly patients with extensive small cell lung cancer diagnosed in our hospital,with recurrence within 6 months after receiving first-line treatment (EP) were collected.The patients were randomly divided into 2 groups.Temozolomide group （22 patients） received 2 cycles.One cycle included 28 days (temozolomide 150 mg／m2 per day，continuous taking for 5 days)．Control group （ 22 patients ） received CPT-P chemotherapy （irinotecan 65 mg／m2,d1,8，intravenously．Cisplatin 75 mg／m2, 3 days,d2~4，intravenously）．The efficacy and toxicity were evaluated after 2 cycles of treatment．Efficient rate，disease control rate，progression-free survival and incidence of adverse reactions were compared between the two groups.Results:The efficacy rates of the temozolomide group and control group were 18％ and 18％． The disease control rates were 23％ and 27％（P＞0.05）.The progression-free survival time for the temozolomide group and control group was 5.3 months and 5.5 months （P＞0.05）.The gastrointestinal reaction,diarrhea and the degree of bone marrow suppression （ grade Ⅲ-Ⅳ ） of the temozolomide group were significantly lower than the control group （P＜0.05）.Conclusion:Temozolomide is one of the most effective chemotherapy regimens for elderly patients with extensive small cell lung cancer who relapsed within 6 months after receiving first-line treatment (EP).The elderly patients are well tolerated.