拓扑替康联合顺铂方案与足叶乙甙联合顺铂方案治疗小细胞肺癌临床疗效的比较研究

摘要

Objective To compare the clinical effect on small cell lung cancer between topotecan combined with cisplatin and etoposide combined with cisplatin. Methods A total of 38 patients with small cell lung cancer were selected in the Central Nongken Hospital of Guangdong province from March 2014 to March 2015,and they were divided into control group and observation group according to RevMan 5. 0 software - induced random number table,each of 19 cases. patients of both groups received hydration treatment and diuretic therapy before chemotherapy,and patients of control group were given etoposide combined with cisplatin, while patients of observation group were given topotecan combined with cisplatin; both groups continuously treated for 2 cycles of chemotherapy(3 weeks as a cycle of chemotherapy),and patients without improvement of disease received 4 cycles of chemotherapy. Clinical effect,survival curve,incidence of toxic and side effects were compared between the two groups. Results No statistically significant differences of clinical effect was found between the two groups(u =1. 787,P > 0. 05). Until to September 2015,9 cases of control group(accounting for 47. 4% )died,8 cases of observation group(accounting for 42. 1% )died,no statistically significant differences of fatality rate was found between the two groups(P> 0. 05). The difference of survival curve was statistically significantly different( log - rank χ2 = 8. 319,P < 0. 05). The median survival time of control group was 7 months,of observation group was 12 months. The incidence of severe gastrointestinal reaction,of severe myelosuppression of control group was 15. 8% ,42. 1% ,respectively,of observation group was 21. 1% , 31. 6% ,respectively,the differences were not statistically significantly different(P > 0. 05). Conclusion The clinical effect of topotecan combined with cisplatin has similar clinical effect with etoposide combined with cisplatin in treating small cell lung cancer,but topotecan combined with cisplatin can effectively lengthen the lifetime without increasing the incidence of toxic and side effects.%目的：比较拓扑替康联合顺铂方案与足叶乙甙联合顺铂方案治疗小细胞肺癌（SCLC）的临床疗效。方法选取2014年3月—2015年3月广东省农垦中心医院收治的 SCLC 患者38例，按照 RevMan 5.0软件生成的随机数字表将患者分为对照组与观察组，每组19例。两组患者化疗前均采取水化利尿治疗，观察组患者给予拓扑替康联合顺铂方案治疗，对照组患者给予足叶乙甙联合顺铂方案治疗；3周为1个化疗周期，2个化疗周期后观察临床疗效，病情无好转者则持续治疗4个化疗周期。比较两组患者的临床疗效、生存曲线及毒副作用发生率。结果两组患者临床疗效比较，差异无统计学意义（u =1.787，P >0.05）。截至2015年9月，观察组中8例（42.1%）患者死亡，对照组中9例（47.4%）患者死亡，两组患者病死率比较，差异无统计学意义（P >0.05）。两组患者生存曲线比较，差异有统计学意义（log - rank χ2=8.319，P <0.05）。观察组患者中位生存时间为12个月，对照组患者中位生存时间为7个月。对照组患者严重胃肠道反应、严重骨髓抑制发生率分别为15.8%、42.1%，观察组分别为21.1%、31.6%，差异无统计学意义（P >0.05）。结论拓扑替康联合顺铂方案与足叶乙甙联合顺铂方案治疗 SCLC 患者的临床疗效相当，但拓扑替康联合顺铂方案能延长患者的生存期，且不增加毒副作用发生率。