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目的:观察伊立替康联合顺铂方案、足叶乙甙联合顺铂方案治疗小细胞肺癌的疗效、生存率和不良反应。方法:小细胞肺癌患者48例随机分为2组。伊立替康联合顺铂方案组(IP组)24例给予伊立替康100 mg/m2,第1,8天静脉滴注;顺铂25 mg/m2,第1~3天静脉滴注。足叶乙甙联合顺铂方案组(EP组)给予足叶乙甙100 mg,第1~5天静脉滴注;顺铂25 mg/m2,第1~3天静脉滴注。2组均21 d为1个治疗周期,2个治疗周期后比较疗效、生存率和不良反应。结果:IP组有效率75.0%,中位生存期12.9个月,1年生存率66.7%,EP组有效率66.7%,中位生存期9.8个月,1年生存率37.5%,2组有效率比较差异无统计学意义(P>0.05),1年生存率比较差异有统计学意义(P<0.05)。2组主要不良反应均为骨髓抑制和胃肠道反应,IP组Ⅲ~Ⅳ度中性粒细胞下降率低于EP组(P<0.05),腹泻发生率高于EP组(P<0.05)。结论:伊立替康联合顺铂治疗小细胞肺癌疗效满意,耐受性优于足叶乙甙联合顺铂方案。
Objective: To observe the efficacy, survival rate and adverse reactions of irinotecan combined with cisplatin and etoposide plus cisplatin in the treatment of small cell lung cancer. Methods: 48 patients with small cell lung cancer were randomly divided into two groups. 24 cases of irinotecan 100 mg / m2 were given irinotecan and cisplatin combination group (ip group), intravenous drip on day 1 and 8; cisplatin 25 mg / m2 on day 1 to 3. Etoposide cisplatin regimen group (EP group) given etoposide 100 mg, intravenous drip 1 to 5 days; cisplatin 25 mg / m2, the first day to 3 days intravenous drip. Both groups were 21 days for a treatment cycle, two treatment cycles more efficacy, survival and adverse reactions. Results: The effective rate of IP group was 75.0%, the median survival time was 12.9 months, the 1-year survival rate was 66.7%, the EP group efficiency was 66.7%, the median survival time was 9.8 months and the 1-year survival rate was 37.5% The difference was not statistically significant (P> 0.05), 1-year survival rate was significantly different (P <0.05). The main adverse reactions in both groups were myelosuppression and gastrointestinal reactions. The rates of neutropenia in group Ⅲ ~ Ⅳ of IP group were lower than those in EP group (P <0.05). The incidence of diarrhea was higher than that in EP group (P <0.05). Conclusion: The combination of irinotecan and cisplatin in the treatment of small cell lung cancer is more effective and tolerant than etoposide and cisplatin.