Liu Xiuju, Guo Qisen
Department of Medical Oncology, Shandong Tumor Hospital, Jinan, Shandong 250117, P.R.China.
Zhongguo Fei Ai Za Zhi. 2006 Oct 20;9(5):458-61. doi: 10.3779/j.issn.1009-3419.2006.05.15.
Chemotherapy is main treatment of small cell lung cancer (SCLC). This aim of this study is to evaluate the effects and the adverse effects of HCE regimen (hydroxycamptothecin + etoposide + carboplatin) in treatment of SCLC.
Patients with previously untreated SCLC were randomized into two groups: HCE group (treated by HCE regimen) and EP group (treated by etoposide and cisplatin). The chemotherapeutic effects and the adverse effects were compared between two groups.
A total of 71 patients could be evaluated. The overall response rate was 90.3% (28/31) for HCE group with 17 complete response (CR) and 11 partial response (PR), and 70.0% (28/40) in the EP group with 9 CR and 19 PR. The CR was significantly different between two groups. The median survival time of the HCE group and EP group were 11.5 and 25 months respectively. The 1-year survival rate was 72.4% vs 69.4% (P > 0.05), 2-year survival rate was 51.7% vs 44.4% (P < 0.05), and 3-year survival rate was 40.0% vs 29.2% (P < 0.05). Myelosuppression, diarrhea and vomiting were the main toxicities in two groups. The incidence of myelosuppression was higher in the HCE group than that in the EP group but without statistical difference (P > 0.05), whereas the incidence of nausea and vomiting were significantly lower than that in the EP group (P < 0.01).
HCE regimen is an effective regimen for previously untreated SCLC with high CR and slight toxicity. It may be worthy of further clinical investigation.
化疗是小细胞肺癌(SCLC)的主要治疗方法。本研究旨在评估HCE方案(羟基喜树碱+依托泊苷+卡铂)治疗SCLC的疗效及不良反应。
将既往未接受过治疗的SCLC患者随机分为两组:HCE组(采用HCE方案治疗)和EP组(采用依托泊苷和顺铂治疗)。比较两组的化疗效果及不良反应。
共有71例患者可进行评估。HCE组的总缓解率为90.3%(28/31),其中完全缓解(CR)17例,部分缓解(PR)11例;EP组的总缓解率为70.0%(28/40),其中CR 9例,PR 19例。两组的CR有显著差异。HCE组和EP组的中位生存时间分别为11.5个月和25个月。1年生存率分别为72.4%和69.4%(P>0.05),2年生存率分别为51.7%和44.4%(P<0.05),3年生存率分别为40.0%和29.2%(P<0.05)。骨髓抑制、腹泻和呕吐是两组的主要毒性反应。HCE组骨髓抑制的发生率高于EP组,但无统计学差异(P>0.05),而恶心和呕吐的发生率显著低于EP组(P<0.01)。
HCE方案是治疗既往未接受过治疗的SCLC的有效方案,CR率高且毒性轻微。可能值得进一步进行临床研究。