天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (7): 788-792.doi: 10.11958/j.issn.0253-9896.2015.07.024

• 药物临床观察 • 上一篇    下一篇

替尼泊苷联合卡铂与依托泊苷联合卡铂一线治疗小细胞肺癌的长期随访研究

陈青青，张会来，王华庆   

  1. 1天津医科大学肿瘤医院淋巴瘤科
    2国家肿瘤临床医学研究中心
    3天津市肿瘤防治重点实验室
  • 收稿日期:2014-08-28 修回日期:2015-03-07 出版日期:2015-07-15 发布日期:2015-07-15
  • 通讯作者: 张会来△ E-mail:cqqfirst@163.com

A long-term follow-up study on the treatment of small cell lung cancer using teniposide/ carboplatin with etoposide/carboplatin as first-line therapy

CHEN Qingqing， ZHANG Huilai， WANG Huaqing   

  1. 1Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital
     2National Clinical Research Center of
    3Cancer, Key Laboratory of Cancer Prevention and Therapy
  • Received:2014-08-28 Revised:2015-03-07 Published:2015-07-15 Online:2015-07-15
  • Contact: ZHANG Huilai△ E-mail:cqqfirst@163.com

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摘要： 目的 长期随访比较替尼泊苷（Teniposide，VM-26）联合卡铂（Carboplatin，CBP）（TC方案）与依托泊苷（Etoposide，VP-16）联合卡铂（EC方案）一线治疗小细胞肺癌（Small cell lung cancer，SCLC）的疗效及对脑转移的预防作用。方法 102例初治、无脑转移的SCLC患者接受治疗，其中EC方案（VP-16组）64例，TC方案（VM-26组）38例，患者一般临床特征经χ2检验，两组具有可比性（P﹥0.05）。化疗后达PR或CR者给予预防性脑照射（prophylactic cranial irradiation, PCI）。结果 VM-26组CR 4例，PR 26例，SD 7例，PD 1例，ORR为78.9%，DCR为97.4%，中位PFS为10个月，中位OS为18个月；VP-16组CR 7例，PR 42例，SD 12例，PD 3例，ORR为76.6%，DCR 95.3%，中位PFS为9个月，中位OS为16个月。VM-26组1、2、3年OS分别为73.7%、36.8%和18.4%；VP-16组1、2、3年OS分别为71.9%、37.5%和18.8%。两组有效率、疾病控制率及生存期均无统计学差异（P﹥0.05）。VM-26组脑转移发生率为21.1%，VP-16组为43.8%，VP-16组明显高于VM-26组，有统计学差异（P=0.020）。不良反应主要是骨髓抑制，多为I、II度，两组比较无统计学差异（ P﹥0.05）。结论 TC方案治疗SCLC疗效肯定，其近期疗效和长期生存与EC方案相似，且该方案一定程度上可降低脑转移发生率，耐受性较好，可作为初治SCLC的一线治疗方案。

关键词: 卡铂, 随访研究, 小细胞肺癌, 替尼泊苷, 依托泊苷

Abstract: Objective To compare the efficacy and toxicity of teniposide plus carboplatin（TC） and etoposide plus carboplatin（EC） in treatment of newly diagnosed SCLC，and the possible role of VM-26 on prevention of brain metastasis of SCLC. Methods A total of 102 previously untreated SCLC patients without brain metastasis were included； 64 patients received EC（VP-16 group） and 38 patients received TC（VM-26 group）. The characteristics of patients were comparable according to χ2 test. One month after chemotherapy all patient get CR or PR began prophylactic cranial irradiation（PCI）. Results The overall response rate was 78.9% for VM-26 group with 4 complete response(CR) and 26 partial response(PR)，and 76.6% in VP-16 group with 7 CR and 42 PR(P=0.826). Median PFS was 10 months（95%CI 7.4～12.6） in VM-26 group and 9 months（95%CI 6.4～11.6）in VP-16 group(P=0.866).Median survival was 18 months（95%CI 16.5～19.5） and 16 months（95%CI 9.9～22.1）in VM-26 group and VP-16 group(P=0.642), reapectively. The 1，2 and 3-year survival rates were 73.7%、36.8% and 18.4% in VM-26 group; and 71.9%、37.5% and 18.8% in VP-16 group(P﹥0.05). The rate of brain metastasis was 21.1% for VM-26 group and 43.8% for VP-16 group(P=0.020). The main toxicity was grade 1/2 mylosuppression，and there was no significant difference between the two groups（P﹥0.05）. Conclusion TC is a highly active regimen for treatment of SCLC；there is no difference in the effectiveness and toxicity versus EC. Application of VM-26 can reduce the incidence of brain metastasis in SCLC patients.

Key words: Carboplatin, follow-up studies, small cell lung cancer, Teniposide, Etoposide