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[目的]比较伊立替康(CPT-11)联合顺铂与依托泊苷(VP-16)联合顺铂(DDP)治疗小细胞肺癌并发胸水的近期疗效及毒副反应。[方法]选择62例小细胞肺癌并发胸水的患者,随机分为两组,分别采用EP(VP-16+DDP)方案及IP(CPT-11+DDP)方案治疗,同时两组均予胸腔闭式引流,胸腔内注射顺铂。[结果]EP组、IP组胸水吸收率分别为53.1%(17/32)、70.0%(21/30),两者疗效有明显差异(P<0.05)。骨髓抑制为剂量限制性毒性,两组相当,其中WBC下降:EP组为37.5%,IP组36.7%;PLT下降:EP组为21.9%,IP组为20.0%;Hb下降:EP组18.8%,IP组20.0%;非血液性毒性方面主要为恶心呕吐,延迟性腹泻及脱发,其中恶心呕吐两组相当,但延迟性腹泻及脱发IP组高于EP组,EP组发生率分别为6.25%、12.5%,IP组发生率分别为16.7%、26.7%。[结论]IP方案较EP方案治疗小细胞肺癌并发胸水的近期疗效好,毒副反应可以耐受。
[Objective] To compare the short-term curative effect and toxicity of irinotecan (CPT-11) combined with cisplatin and etoposide (VP-16) and cisplatin (DDP) in the treatment of small cell lung cancer complicated with pleural effusion. [Methods] Sixty-two patients with small cell lung cancer complicated with pleural effusion were randomly divided into two groups and were treated with EP (VP-16 + DDP) and IP (CPT-11 + DDP) Drainage, intrapleural injection of cisplatin. [Results] The pleural effusion rates of EP group and IP group were 53.1% (17/32) and 70.0% (21/30), respectively. There was significant difference between the two groups (P <0.05). Myelosuppression was dose-limiting. The WBC decreased: 37.5% in EP group and 36.7% in IP group; PLT decreased: 21.9% in EP group and 20.0% in IP group; Hb decreased: 18.8% in EP group, IP group 20.0%; non-haematological toxicity mainly nausea and vomiting, delayed diarrhea and hair loss, nausea and vomiting in both groups, but delayed diarrhea and hair loss IP group was higher than the EP group, EP group incidence rates were 6.25% 12.5% respectively. The incidence of IP group was 16.7% and 26.7% respectively. [Conclusion] The IP regimen is better than EP regimen in the treatment of small cell lung cancer with pleural effusion, and the side effects are tolerable.