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目的观察伊立替康联合顺铂和犀黄丸治疗局限期小细胞肺癌临床疗效及安全性。方法 100例局限期小细胞肺癌患者随机分为对照组50例与试验组50例,对照组予以静脉滴注盐酸伊立替康注射液60 mg·m~(-2),每周期第1,8日,顺铂注射液75 mg·m-2静脉滴注,每周期第1日,试验组在对照组的基础上给予口服犀黄丸6 g,每日1次。2组患者均21 d为1个周期,共治疗4个周期。治疗结束后比较2组临床疗效、血清乳酸脱氢酶(LDH)、组织多肽特异抗原(TPS)、胃泌素释放肽前体(Pro GRP)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、鳞状细胞癌抗原(SCC)、细胞角蛋白19片段(CYFR21-1)、总生存率及药物不良反应发生情况。结果治疗后,试验组和对照组的总有效率分别为88.00%(44/50例)和60.00%(30/50例)(P<0.05)。治疗后,对照组与试验组LDH分别为(301.29±45.37),(232.78±33.57)U·L~(-1),TPS分别为(57.29±6.39),(48.39±4.90)U·L~(-1),Pro GRP分别为(57.39±8.79),(22.91±4.70)U·L~(-1),NSE分别为(19.29±2.91),(13.29±1.89)μg·L~(-1),CEA分别为(7.38±1.61),(5.24±0.87)μg·L~(-1),SCC分别为(3.29±0.72),(2.12±0.34)ng·L~(-1),CYFR21-1分别为(4.49±0.73),(2.40±0.38)ng·L~(-1),差异有统计学意义(P<0.05)。试验组出现恶心呕吐3例,脱发2例,总药物不良反应发生率为10.00%(5/50例),对照组出现恶心呕吐3例,头疼2例,脱发2例,总药物不良反应发生率为14.00%(7/50例),差异无统计学意义(P>0.05)。试验组死亡4例,总生存率为92.00%(46/50例),对照组死亡15例,总生存率为70.00%(35/50例),差异有统计学意义(P<0.05)。结论伊立替康联合顺铂和犀黄丸治疗局限期小细胞肺癌的临床疗效显著提高,且不增加药物不良反应发生率。
Objective To observe the clinical efficacy and safety of irinotecan combined with cisplatin and rhubarb Huang Wan in the treatment of small cell lung cancer. Methods One hundred patients with localized small cell lung cancer were randomly divided into control group (n = 50) and experimental group (n = 50). The control group was given IV irinotecan hydrochloride injection 60 mg · m ~ (-2) Day, cisplatin injection 75 mg · m-2 intravenous infusion, the first day of each cycle, the experimental group was given on the basis of the control group rhubarb powder 6 g, 1 day. Two groups of patients were 21 d for a cycle, a total of 4 cycles. After treatment, the clinical efficacy, serum LDH, TPS, Pro GRP, NSE, Embryo antigen (CEA), squamous cell carcinoma antigen (SCC), cytokeratin 19 fragment (CYFR21-1), overall survival and adverse drug reactions. Results After treatment, the total effective rate was 88.00% (44/50) and 60.00% (30/50) in the experimental group and the control group (P <0.05). After treatment, the LDH of control group and experimental group were (301.29 ± 45.37) and (232.78 ± 33.57) U · L -1, respectively. The TPS were (57.29 ± 6.39) and (48.39 ± 4.90) U · L ~ -1 and Pro GRP were (57.39 ± 8.79) and (22.91 ± 4.70) U · L -1, respectively. The values of NSE were (19.29 ± 2.91) and (13.29 ± 1.89) μg · L -1, , CEA were (7.38 ± 1.61) and (5.24 ± 0.87) μg · L -1, SCC were (3.29 ± 0.72) and (2.12 ± 0.34) ng · L -1, respectively, and CYFR21-1 (4.49 ± 0.73) and (2.40 ± 0.38) ng · L -1, respectively, with significant difference (P <0.05). There were 3 cases of nausea and vomiting, 2 cases of hair loss and 10.00% (5/50) cases of total adverse drug reactions in the test group. There were 3 cases of nausea and vomiting, 2 cases of headache and 2 cases of hair loss in the control group. The incidence of adverse drug reactions 14.00% (7/50 cases), the difference was not statistically significant (P> 0.05). There were 4 deaths in the experimental group, the overall survival rate was 92.00% (46/50 cases), and 15 cases died in the control group. The overall survival rate was 70.00% (35/50 cases). The difference was statistically significant (P <0.05). Conclusion The clinical efficacy of irinotecan combined with cisplatin and rhubarb Huangwan in the treatment of SCLC was significantly improved without increasing the incidence of adverse drug reactions.