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目的评价奈达铂联合依托泊苷治疗初发和复发小细胞肺癌(SCLC)的临床疗效和不良反应。方法选取2011年1月至2014年7月间重庆新桥医院收治的SCLC患者87例,其中初发41例,复发46例,全组SCLC患者分别按随机数字表法分为观察组和对照组。观察组患者使用奈达铂+依托泊苷静脉滴注,对照组患者使用顺铂+依托泊苷静脉滴注。对初发和复发两组患者的近期、远期疗效和不良反应进行比较。结果治疗6个周期后,初发患者中观察组和对照组的近期有效率分别为81.0%和70.0%,复发患者中观察组和对照组分别为78.3%和69.6%,差异均无统计学意义(均P>0.05)。同时各组患者生存率和生存期比较差异无统计学意义(P>0.05)。初发和复发SCLC患者中,观察组和对照组患者在贫血、脱发、发热、乏力、白细胞减少、血小板减少、神经毒性、肝功能异常和心电图异常方面的不良反应发生率和严重程度均无统计学意义(均P>0.05),但对照组患者腹泻、便秘、恶心呕吐等胃肠道道反应和肾功能异常发生率高于观察组,差异有统计学意义(P<0.01)。结论奈达铂联合依托泊苷治疗初发和复发SCLC具有明显的疗效,并且胃肠道和肾不良反应发生率较低,值得进一步推广应用。
Objective To evaluate the clinical efficacy and adverse reactions of nedaplatin combined with etoposide in the treatment of primary and recurrent small cell lung cancer (SCLC). Methods 87 patients with SCLC admitted to Xinqiao Hospital of Chongqing from January 2011 to July 2014 were recruited. Among them, 41 cases were newly diagnosed and 46 cases were relapsed. All the patients with SCLC were divided into observation group and control group according to random number table. . Patients in the observation group received intravenous nedaplatin + etoposide, and patients in the control group received intravenous cisplatin plus etoposide. Short-term, long-term efficacy and adverse reactions were compared between the two groups. Results After six cycles of treatment, the recent effective rates of the observation group and the control group were 81.0% and 70.0%, respectively, and the recurrence patients were 78.3% and 69.6% in the observation group and the control group respectively, with no significant difference (All P> 0.05). At the same time, there was no significant difference in survival rate and survival between the two groups (P> 0.05). In both primary and recurrent SCLC patients, there was no statistical significance in the incidence and severity of adverse reactions in patients in the observation and control groups with regard to anemia, hair loss, fever, fatigue, leukopenia, thrombocytopenia, neurotoxicity, liver dysfunction and electrocardiographic abnormalities (P> 0.05). However, the incidence of gastrointestinal reactions and renal dysfunction such as diarrhea, constipation, nausea and vomiting in the control group was significantly higher than that in the observation group (P <0.01). Conclusion Nedaplatin combined with etoposide has a significant curative effect in the treatment of primary and recurrent SCLC, and the incidence of gastrointestinal and renal adverse reactions is low, which is worth further promotion and application.