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目的观察含伊立替康(CPT-11)方案二线治疗广泛期小细胞肺癌的疗效及不良反应。方法回顾性分析2008年1月1日~2015年10月1日63例在我院接受含伊立替康方案二线治疗的广泛期小细胞肺癌患者的临床资料。每个周期根据WHO抗癌药物毒性反应评价标准进行不良反应分级,每2周期后按实体瘤客观疗效评价标准(RECIST)1.1版评价疗效,统计临床有效率和不良反应发生率,对单用依立替康和IP方案组的药物疗效进行比较,并采用Kaplan-Meier进行生存分析。结果 63例患者中完全缓解(CR)1例(1.6%),部分缓解(PR)17例(27.0%),稳定(SD)21例(33.3%),进展(PD)24例(38.1%),总体客观缓解率(CR+PR)28.6%,疾病控制率(CR+PR+SD)61.9%.IP方案组的ORR为35.4%,高于单用依立替康方案组6.7%(χ~2=4.629,P<0.05)。中位无进展生存期3.9个月,中位总生期11.3个月。严重不良反应包括骨髓抑制3级以上10例(15.9%)、恶心呕吐3级以上5例(7.9%)、迟发性腹泻3级以上2例(3.2%),无治疗相关性死亡。结论含伊立替康方案二线治疗广泛期小细胞肺癌近期疗效确切,IP方案组有较好的疾病缓解率,不良反应可耐受。
Objective To observe the efficacy and side effects of second-line treatment of small-cell lung cancer with irinotecan (CPT-11) regimen. Methods The clinical data of 63 patients with extensive stage of small cell lung cancer undergoing second-line therapy with irinotecan in our hospital from January 1, 2008 to October 1, 2015 were retrospectively analyzed. Each cycle according to the WHO anti-cancer drug toxicity evaluation criteria for adverse reaction grading, every 2 cycles according to objective evaluation of solid tumors Objective Evaluation Criteria (RECIST) version 1.1 evaluation of clinical efficacy, clinical efficacy and adverse reaction rates, The efficacy of the drug was compared to that of the ip regimen and the Kaplan-Meier survival analysis. Results The complete remission (CR) in 1 patient (1.6%), partial remission (PR) in 17 patients (27.0%), stable (SD) in 21 patients (33.3%) and progression (PD) in 24 patients (38.1% (CR + PR), disease control rate (CR + PR + SD) was 61.9%, ORR was 35.4% in IP group, which was higher than 6.7% (χ ~ 2 = 4.629, P <0.05). The median progression-free survival of 3.9 months, the median total life of 11.3 months. Serious adverse reactions included 10 cases (15.9%) with grade 3 or higher myelosuppression, 5 cases (7.9%) with grade 3 or above nausea and vomiting, and 2 cases (3.2%) with grade 3 or more with delayed diarrhea without treatment-related death. Conclusion The second-line therapy with irinotecan has the short-term curative effect in the treatment of extensive-stage small cell lung cancer. The IP regimen group has better disease remission rate and adverse reactions are tolerable.