吉西他滨联合多西他赛三线治疗复发小细胞肺癌临床观察.docVIP

吉西他滨联合多西他赛三线治疗复发小细胞肺癌临床观察 　　[摘要] 目的 探讨吉西他滨联合多西他赛三线治疗对复发小细胞肺癌患者生存期的影响。 方法 将我院经依托泊苷联合铂类（EP）及伊立替康联合铂类（IP）化疗后复发或无效的小细胞肺癌患者随机分为三线化疗组和支持治疗组，比较两组患者生存期。 结果 三线化疗组有效率19.35%（6/31），疾病控制率35.48%（11/31），中位生存时间17（13，21）周，支持治疗组中位生存时间13（12，14）周，两组生存期比较，差异具有统计学意义（P0.05），两组中局限期患者生存期比较，差异具有统计学意义（P0.05），而广泛期患者生存期比较无统计学意义。 结论 吉西他滨联合多西他赛对复发或无效的局限期小细胞肺癌有一定的疗效，可以考虑作为三线治疗方案。 　　[关键词] 吉西他滨；多西他赛；小细胞肺癌；三线治疗 　　[中图分类号] R734.2 [文献标识码] B [文章编号] 2095-0616（2015）19-97-04 　　[Abstract] Objective To investigate the effect of gemcitabine plus docetaxel as the third line therapy on the survival time of patients with recurrent small cell lung cancer. Methods The patients with small cell lung cancer in our hospital who had a relapse or invalid treatment after chemotherapy with etoposide combined with cisplatin （EP） and irinotecan combined with cisplatin （IP） were randomly divided into three line chemotherapy group and support treatment group. The patients survival time of these two groups were compared. Results The effective rate of Three Line Chemotherapy Group was 19.35% （6/31） and the disease control rate was 35.48% （11/31）. The median survival time of Three Line Chemotherapy Group was 17 weeks （13， 21） while that of the support group was 13 weeks （12， 14）. There was a statistically significant difference in the survival time between the two groups （P0.05）. Specifically， there was a statistically significant difference in the survival time between the two groups in local stage（P0.05）， but there was no significant difference between the survival time in extensive stage. Conclusion Gemcitabine plus docetaxel have a certain curative effect on refractory small cell lung cancer in limited stage and can be considered as a third line treatment. 　　[Key words] Docetaxel； Gemcitabine； Small cell lung cancer； Third line therapy 　　肺癌是世界上发病率及死亡率最高的恶性肿瘤，其中大约有13%的患者为小细胞肺癌[1]。虽然小细胞肺癌对放化疗较为敏感，但由于其恶性程度高，易早期复发和转移，治疗效果并不理想。目前NCCN指南将“EP”方案作为小细胞肺癌的标准方案，联合放疗有效期可达70%～90%，而广泛期患者“IP”方案亦为首选方案之一，有效率可达60%～70%。然而，大多数小细胞肺癌复发后均会耐药，