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目的比较伊立替康(CPT-11)联合洛铂或顺铂(DDP)二线治疗经治后6个月内复发或转移的晚期小细胞肺癌,观察近期疗效和毒副反应。方法收集41例经治复发及进展的广泛期小细胞肺癌病例,以抽签方式随机分为实验组和对照组。实验组21例,采用洛铂(LBP)30mg/m2,d1,伊立替康(CPT-11)65mg/m2,d1、8,21d为1周期;对照组20例,采用CPT-11 65mg/m2,d 1、8,DDP 25mg/m2,d1~3,21d为1周期。病例至少完成2周期化疗。结果两组间客观缓解率、疾病控制率、生存时间无差异(P>0.05);实验组平均无进展生存时间有所延长(P=0.04);毒副反应中,实验组治疗后Ⅲ~Ⅳ度血小板减少发生率38.1%,对照组为20%,差异具有统计学意义(P=0.03);实验组治疗后Ⅲ~Ⅳ度恶心呕吐发生率为9.5%,对照组为35%,差异也具有统计学意义(P=0.049)。结论 CPT-11联合LBP方案二线治疗复发或转移小细胞肺癌(SCLC)在控制肿瘤进展方面较CPT-11联合DDP方案有一定优势,而且毒副反应可耐受。
Objective To compare the efficacy and toxicity of late-stage small-cell lung cancer with irinotecan (CPT-11) and lobaplatin or cisplatin (DDP) in the second stage of relapse or metastasis after 6 months of treatment. Methods A total of 41 cases of extensive stage small cell lung cancer with relapse and progression were collected and randomly divided into experimental group and control group by lottery. The experimental group consisted of 21 cases of LBP 30 mg / m2, d1, 65 mg / m2 of irinotecan (CPT-11) and 1 cycle of d1, 8 and 21 days. The control group consisted of 20 cases of CPT-11 65mg / m2 , d 1,8, DDP 25mg / m2, d1 ~ 3,21d for one cycle. Cases completed at least 2 cycles of chemotherapy. Results There was no significant difference in objective response rate, disease control rate and survival time between the two groups (P> 0.05). The mean progression-free survival time of the experimental group was prolonged (P = 0.04) The incidence of thrombocytopenia was 38.1% in the control group and 20% in the control group (P = 0.03). The incidence of grade Ⅲ ~ Ⅳ degree nausea and vomiting in the experimental group was 9.5% and that in the control group was 35% Statistical significance (P = 0.049). Conclusions The second-line treatment with CPT-11 combined with LBP regimen has a certain advantage over CPT-11 combined with DDP regimen in the control of tumor recurrence or metastasis of small cell lung cancer (SCLC), and the toxic side effects are tolerable.