广泛期小细胞肺癌 EP 一线化疗后口服 VP-16维持治疗的临床疗效观察

摘要

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 (P<0.05). The oral administration group had obviously higher PFS as (5.73±0.26) months than (4.51±0.75) months of the blank group, and the difference had statistical significance (P<0.01). There was no statistically significant difference of 1-year survival rate between the oral administration group and the blank group as 88% and 80% (P>0.05). 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 (P<0.05). The difference of incidence of toxic reaction between the oral administration group and the blank group had no statistical significance as 60% and 64% (P>0.05). 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.%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(P<0.05)。口服组PFS(5.73±0.26)个月明显高于空白组的(4.51±0.75)个月 ,差异具有统计学意义(P<0.01)。口服组1年生存率88%与空白组80%比较差异无统计学意义(P>0.05),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(P<0.05)。口服组毒性反应发生率60%与空白组的64%比较差异无统计学意义(P>0.05)。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。