依托泊苷及伊立替康联合铂类化疗对广泛期小细胞肺癌的疗效及安全性分析

李能升; 李力; 何勇

doi:10.16016/j.1000-5404.201808023

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依托泊苷及伊立替康联合铂类化疗对广泛期小细胞肺癌的疗效及安全性分析

临床医学 | 更新时间：2026-01-09

- 依托泊苷及伊立替康联合铂类化疗对广泛期小细胞肺癌的疗效及安全性分析
- Efficacy and safety of irinotecan/platinum versus etoposide/platinum chemotherapy for extensive-stage small cell lung cancer
- 第三军医大学学报 2019年41卷第2期页码：124-129
- 作者机构：
  
  400042 重庆，陆军军医大学(第三军医大学)第三附属医院(野战外科研究所)呼吸内科
- 作者简介：
  
  [ 何勇，E-mail：heyong8998@126.com HE Yong, E-mail: heyong8998@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201808023
  中图分类号： R181.23;R734.2;R979.1
- 收稿：2018-08-04，
  
  修回：2018-11-05，
  
  纸质出版：2019-01-30
- 稿件说明：
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李能升, 李力, 何勇. 依托泊苷及伊立替康联合铂类化疗对广泛期小细胞肺癌的疗效及安全性分析[J]. 第三军医大学学报, 2019,41(2):124-129.

Nengsheng LI, Li LI, Yong HE. Efficacy and safety of irinotecan/platinum versus etoposide/platinum chemotherapy for extensive-stage small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(2): 124-129.
李能升, 李力, 何勇. 依托泊苷及伊立替康联合铂类化疗对广泛期小细胞肺癌的疗效及安全性分析[J]. 第三军医大学学报, 2019,41(2):124-129. DOI： 10.16016/j.1000-5404.201808023.

Nengsheng LI, Li LI, Yong HE. Efficacy and safety of irinotecan/platinum versus etoposide/platinum chemotherapy for extensive-stage small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(2): 124-129. DOI： 10.16016/j.1000-5404.201808023.

摘要

目的

对比广泛期小细胞肺癌(small cell lung cancer

SCLC)采用依托泊苷联合铂类化疗(etoposide plus platinum

EP)与伊立替康联合铂类化疗(irinotecan plus platinum

IP)两种方案的疗效及安全性。

方法

回顾性分析2013-2017年陆军军医大学第三附属医院收治的144例SCLC患者，其中一线接受EP方案化疗65例(EP组)，一线接受IP方案化疗79例(IP组)。对比EP组和IP组疗效及安全性，分析放疗及淋巴细胞亚群对生存的影响。

结果

EP组和IP组客观缓解率(Objective response rate

ORR)分别为67.7%(44/65)、57.0%(45/79)，差异无统计学意义(

=0.243)；EP组和IP组中位无进展生存期(median progression-free survival

mPFS)、中位生存时间(median overall survival

mOS)无明显差异(5.05

4.30个月，

=0.650；13.95

14.10个月，

=0.120)。无论EP组还是IP组，联合胸部放疗均可以显著延长mPFS及mOS。淋巴细胞亚群T4、T8总数降低患者mPFS、mOS明显低于淋巴细胞亚群T4、T8总数正常者。3/4级以上毒副反应方面：IP组腹泻发生率为46.8%，显著高于EP组(7.7%，

=0.020)；EP组中性粒细胞减少发生率为52.3%，显著高于IP组(22.8%，

=0.001)；EP组贫血发生率为73.8%，显著高于IP组(40.5%，

=0.013)。

结论

对于SCLC患者，EP方案与IP方案疗效无明显差异，联合胸部放疗可显著改善患者预后，淋巴细胞亚群中T4、T8总数正常患者较低下患者预后好，EP组中性粒细胞减少及贫血发生率高，IP组腹泻发生率高。

Abstract

Objective

To compare the efficacy and safety of etoposide plus platinum (EP) and irinotecan plus platinum (IP) regimens for treatment of extensive-stage small cell lung cancer (SCLC).

Methods

This retrospective study was conducted among 144 patients with extensive-stage SCLC receiving chemotherapy with EP regimen (65 cases) or IP regimen (79 cases) in our hospital during the period from 2013 to 2017. Twenty-two patients in EP group and 30 in IP group also received adjuvant radiotherapy. We compared the Objective response rate (ORR) and safety of these 2 regimens

and analyzed the effects of radiotherapy and lymphocyte subset distribution on the survival outcomes of the patients.

Results

No significant difference was found between EP and IP groups in the ORR

disease control rate

median progression-free survival time

or medial overall survival time (mOS; 13.95

14.10 months

=0.120). In both groups

the combination of chest radiotherapy significantly improved the mPFS and mOS of the patients as compared with chemotherapy alone. The patients with lowered counts of T4 and T8 lymphocyte subpopulations had significantly shorter mPFS and mOS than those with normal T4 and T8 cell counts. Compared with IP regimen

EP regimen was associated with a significantly lower incidence of diarrhea (7.7%

46.8%

=0.020) but higher incidences of neutropenia (52.3%

22.8%

=0.001) and anemia (73.8%

40.5%

=0.013).

Conclusion

The therapeutic efficacy of EP and IP regimens is comparable for treatment of extensive-stage SCLC

and adjuvant radiotherapy can significantly improve the clinical outcomes of the patients. The patients with reduced counts of T4 and T8 lymphocyte subsets have poorer outcomes than those with normal counts. EP regimen is associated with high incidences of neutropenia and anemia

and IP regimen with a high incidence of diarrhea in the patients.

关键词

Keywords

references

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