依立替康联合卡铂方案治疗复治小细胞肺癌临床观察.doc

依立替康联合卡铂方案治疗复治小细胞肺癌临床观察 　 作者：卢红阳 马胜林 郭勇 叶魏武 蔡菊芬 王晓稼 【摘要】 　　目的 依立替康在SCLC的化疗中有较好的疗效，本试验旨在观察依立替康联合卡铂(IC)方案二线或三线治疗SCLC的疗效和毒副作用。方法 11例SCLC患者接受IC方案二线或三线化疗，评价疗效及毒副作用。结果 全组中位生存期8个月，临床获益率54.5%，有效率27.3%，完全缓解率0%；全组Ⅲ度加Ⅳ度白细胞下降率36.4%，中性粒细胞下降率36.4%，血小板减少率9.1%，贫血发生率0；Ⅰ度加Ⅱ度腹泻发生率18.2%，Ⅲ度加Ⅳ度腹泻发生率0，Ⅰ度加Ⅱ度肝功能损害的发生率54.5%，Ⅲ度加Ⅳ度肝功能损害的发生率0。 结论 IC方案是治疗复治的SCLC的有效方案，IC方案引起的迟发性腹泻是可以控制的。 【关键词】 依立替康 卡铂 癌 小细胞 　　【Abstract】 Objective Irinotecan is effective for the treatment of small cell lung cancer (SCLC) . The objective of this trial is to assess the efficacy and toxicity of combined chemotherapy regimen of irinotecan plus carboplatin ( IC) in the second line or thirdly treatment of SCLC. Methods A clinical trial including 11 patients was conducted in which the IC regimen was the second-line or third-line regimen for the treatment of patients with SCLC. All patients were given more than two chemotherapy cycles if the regimen is effective. Results The median survival time was eight months.The clinical response rate was 54.5%. The overall response rate was 27.3%.The complete response rate was 0%.Grade 3-4 of myelosuppressions such as leucopenia , neutropenia, thrombocytopenia and anemia were 36.4%,36.4%,9.1% and 0%. Grade 1-2 of diarrhea was18.2% and grade 3-4 of diarrhea was 0%. Grade 1-2 of impairment of liver function is 54.5% and grade 3-4 of impairment of liver function is 0%. Conclusion IC regimen is an effective regimen for relapse SCLC. The delayed diarrhea induced by irinotecan can be controlled by appropriate treatment . 　　【Key words】 Irinotecan Carboplatin Small cell lung cancer 　　为评价依立替康(irinotecan , CPT-11) 加卡铂( IC)方案治疗复治的小细胞肺癌( small cell lung cancer，SCLC) 的疗效与毒副作用，本科于2006年2月至2007年8月对11例复治的SCLC患者给予IC方案化疗，现将结果报告如下。 　　 　　1 资料与方法 　　1.1 一般资料 11例均经病理学确诊的复治的SCLC患者，男10例，女1例，年龄40～66岁(中位年龄52岁)；KPS 评分≥70 分；化疗前心电图及血象、肝肾功能均正常，预计生存期>2个月。所有患者均曾接受过足叶乙甙加顺铂或类似方案治疗。IC方案作为二线治疗的9例，其中足叶乙甙加顺铂一线化疗后无效或3个月内复发4例，3个月后进展3例，艾素加奥沙利铂一线化疗后无效1例，足叶乙甙加卡铂一线化疗后无效1例。IC方案作为三线治疗的2例，1例为足叶乙甙加顺铂一线化疗后进展，足叶乙甙加顺铂再加异环磷酰胺二线化疗后3