不同化疗方案治疗复合性小细胞肺癌的效果和安全性比较

摘要

目的 分析不同化疗方案治疗复合性小细胞肺癌(CSCLC)的效果和安全性.方法 收集2001年8月至2015年9月于佳木斯市中心医院就诊的178例CSCLC患者的病历资料,53例接受三药方案化疗(三药方案组,紫杉醇+顺铂或卡铂+依托泊苷),125例接受两药方案化疗(两药方案组,顺铂或卡铂+依托泊苷).评价2组患者的近期疗效及不良反应.通过随访统计总生存期及无进展生存期(PFS).结果 三药方案组的有效率和疾病控制率均明显高于两药方案组[75.5％ (40/53)比52.0％(65/125),P =0.005;92.5％ (49/53)比78.4％(98/125),P=0.014].三药方案组骨髓抑制、恶心呕吐、肝功能损害比例明显低于两药方案组,腹泻、皮疹比例明显高于两药方案组(均P＜0.01).三药方案组按期完成化疗计划的患者比例高于两药方案组[22.6％(12/53)比16.0％(20/125),P=0.008],但三药方案组肿瘤进展和死亡患者比例高于两药方案组[49.1％ (26/53)比36.8％(46/125),P=0.008;11.3％ (6/53)比8.8％(11/125),P=0.006].三药方案组的总生存期及PFS均优于两药方案组,差异有统计学意义(P =0.042,0.035).结论 与两药化疗方案治疗CSCLC相比,三药方案的近期疗效更高而不良反应较低,但肿瘤进展和死亡患者的比例较高;三药方案组患者的总生存期及PFS更优.%Objective To analyze the efficacy and safety of different chemotherapy regimens in treating combined small cell lung cancer(CSCLC).Methods Totally 178 cases of CSCLC from August 2001 to September 2015 in Jiamusi Central Hospital were enrolled;53 patients had chemotherapy with paclitaxel + cisplatin/carboplatin + etoposide(triple-drugs group);125 patients had chemotherapy with cisplatin/carboplatin + etoposide (dual-drugs group).Short-term efficacy and safety were evaluated.Overall survival(OS) and progression free survival(PFS) were analyzed.Results The effective rate and disease control rate in triple-drugs group were significantly higher than those in dual-drugs group[75.5％ (40/53) vs 52.0％ (65/125),P =0.005;92.5％ (49/53) vs 78.4％ (98/125),P =0.014].Incidences of bone marrow suppression,nausea,vomiting,liver function damage in triple-drugs group were significantly lower and incidences of diarrhea,erythra were significantly higher than those in dual-drugs group(P ＜ 0.01).The completion rate of chemotherapy in triple-drugs group was significantly higher than that in dual-drugs group[22.6％ (12/53) vs 16.0％ (20/125),P =0.008];but the tumor progression rate and death rate in triple-drugs group were higher than those in dual-drugs group [49.1％ (26/53) vs 36.8％ (46/125),P =0.008;11.3％ (6/53) vs 8.8％ (11/125),P =0.006].In triple-drugs group,OS and PFS were significantly better than those in dual-drugs group (P =0.042,0.035).Conclusions Chemotherapy with triple-drugs has higher short-term effective rate and lower adverse reaction rate than dual-drugs in the treatment of CSCLC,but it is also associated with higher rates of tumor progression and death.PFS and OS data of triple-drugs chemotherapy are good.