广泛期小细胞肺癌EP一线化疗后口服VP―16维持治疗临床疗效观察.docVIP

广泛期小细胞肺癌EP一线化疗后口服VP―16维持治疗临床疗效观察 　　【摘要】 目的 观察广泛期小细胞肺癌（SCLC）患者顺铂联合依托泊苷（EP）一线化疗后口服依托泊苷（VP-16）维持治疗的临床疗效。方法 50例广泛期SCLC患者经EP一线治疗后随机分为口服组与空白组， 各25例。口服组口服VP-16 （25 mg， b.i.d.， d1～20）维持治疗， 空白组给予临床观察， 4～6个治疗周期后对比两组临床疗效、无进展生存期（PFS）、总生存期（OS）与毒性反应情况。结果 口服组总有效率、临床获益率分别为44%、88%， 均高于空白组的32%、72%， 差异具有统计学意义（P0.05）， 而口服组2年生存率32%明显高于空白组的20%， 差异具有统计学意义（P0.05）。结论 广泛期SCLC患者EP一线化疗后口服VP-16维持治疗可以明显延长患者的生存期， 而且患者对VP-16毒性反应可耐受， 可以作为广泛期SCLC持续治疗的首选用药方案在临床中推广应用。 　　【关键词】 广泛期小细胞肺癌；顺铂；依托泊苷 　　【Abstract】 Objective To observe clinical effect by oral administration of etoposide （VP-16） for maintenance treatment after cisplatin combined with etoposide （EP） first-line chemotherapy in extensive stage small-cell lung cancer （SCLC） patients. Methods A total of 50 patients with extensive stage SCLC were randomly divided into oral administration group and blank group after EP first-line chemotherapy， and each group contained 25 cases. The oral administration group received VP-16 for maintenance treatment （25 mg， b.i.d.， d1～20）. The blank group received clinical observation. After 4～6 courses， comparisons were made on clinical effects， progression free survival （PFS）， overall survival （OS） and toxic reactions between the two groups. Results The oral administration group had total effective rate and clinical benefit rate as 44% and 88%， and they were all higher than 32% and 72% of the blank group. Their difference had statistical significance （P0.05）. The oral administration group had much higher 2-year survival rate as 32% than 20% of the blank group， and their difference had statistical significance （P0.05）. Conclusion Oral administration of VP-16 for maintenance treatment after EP first-line chemotherapy in extensive stage SCLC patients can remarkably prolong survival time， and the patients had tolerable toxic reaction of VP-16. This method can be clinically promoted and applied as the preferred medication method for treating extensive stage SCLC. 　　【Key words】 Extensive stage small-cell lung cancer； C