法国波尔多大学医院应用阿霉素、足叶乙甙、异环磷酰胺联合治疗69例小细胞肺癌病例的回顾分析

背景与目的:小细胞肺癌(smallcelllungcancer,SCLC)主要治疗原则为多药联合化疗,法国波尔多大学医院呼吸科应用阿霉素、足叶乙甙、异环磷酰胺联合(AVI方案)治疗SCLC10余年,本研究回顾性分析该院应用AVI方案治疗SCLC的疗效及不良反应,以探讨AVI方案在SCLC治疗中的应用价值。方法:收集法国波尔多大学医院呼吸科自1994年1月至2003年12月收治的69例接受AVI化疗的SCLC患者完整的病例资料,分析AVI化疗的有效率、不良反应和患者的生存期。结果:69例患者中,局限期(limiteddisease,LD)23例,扩散期(extendeddisease,ED)46例,化疗总有效率(OR)为60.9%,对LD和ED,OR分别为78.3%和52.2%(P=0.04),中位无进展生存期分别为11.2个月和6.7个月,中位生存期分别为11.3个月和7.2个月,1年生存率分别为47.8%和30.4%,3～4度粒细胞减少,贫血,恶心呕吐发生率分别为34.8%、15.9%、18.8%。结论:AVI治疗SCLC疗效好,主要不良反应为粒细胞减少、贫血和恶心呕吐,可作为临床实际工作中SCLC化疗方案的选择。

Efficacy of adriamycin, etoposide plus ifosfamide on small cell lung cancer--a retrospective analysis of 69 cases treated in Centre Hospitalo-Universitaire de Bordeaux

BACKGROUND & OBJECTIVE: Combined chemotherapy is the major therapeutic principle for small cell lung cancer (SCLC). Adriamycin, etoposide plus ifosfamide (AVI) regimen has been used to treat SCLC for more than 10 years in Service of Respiratory Diseases, CHU de Bordeaux. This study was to analyze retrospectively the efficacy of AVI regimen on SCLC, and observe the adverse events. METHODS: We collected medical documents of 69 SCLC patients, treated wih AVI regimen in Service of Respiratory Diseases, CHU de Bordeaux, Hopital du Haut Leveque from Jan. 1994 to Dec. 2003. Response rate, adverse events, and survival were evaluated. RESULTS: Of the 69 patients, 23 had limited disease (LD), 46 had extended disease (ED). The total objective response rate (OR) was 60.9% for all patients; it was significantly higher in LD patients than in ED patients (78.3% vs. 52.2%, P=0.04). The median progression-free survival time was 11.2 months for LD patients and 6.7 months for ED patients. The median survival time was 11.3 months for LD patients and 7.2 months for ED patients. The 1-year survival rate was 47.8% for LD patients and 30.4% for ED patients. Major adverse events included grade 3-4 neutropenia (34.8%), anemia (15.9%), nausea and vomit (18.8%). CONCLUSIONS: AVI regimen is effective for SCLC. The major adverse events are neutropenia, anemia, nausea and vomit. In practice, AVI regimen could be a chemotherapeutic choice for SCLC.