Pu Dan, Hou Mei, Li Zhixi, Zeng Xiaomei
Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhongguo Fei Ai Za Zhi. 2013 Jan;16(1):20-4. doi: 10.3779/j.issn.1009-3419.2013.01.04.
Etoposide combined cisplatin (EP) is the most commonly-used first-line treatment combination chemotherapy regimen in the treatment of extensive-stage small cell lung cancer (SCLC), The side-effects of cisplatin, such as nausea and vomiting, influence patients' quality of life. This study aims to compare the efficacy and toxicities between etoposide plus oxaliplatin (EO) and etoposide plus cisplatin (EP) regimens as first-line chemotherapy for elderly patients with SCLC.
Seventy-one old, extensive-stage SCLC patients, who had not received anti-tumor treatment, were randomly divided into two groups, namely, EO group (etoposide: 80 mg/m² d1-5+oxaliplatin; 130 mg/m² d1; repeated every 21 days) and EP group (etoposide: 80 mg/m² d1-5+cisplatin; 25 mg/m² d1-3; repeated every 21 days). Efficacy and toxicities were evaluated after 2 or more cycles.
No statistical differences were observed between the EO and EP groups in the response rate (55.9% vs 54.3%, P=0.894), disease control rate (82.4% vs 77.1%, P=0.591), median progression free survival (5.5 months vs 4.7 months, P=0.638), and median survival time (10.5 months vs 9.1 months, P=0.862). In terms of toxicities, the incidence of nausea/vomiting in the EO group was significantly lower than that in the EP group (65.7% vs 97.2%, P=0.001), but the neurotoxicity of grade 1-2 in the EO group was more significant (74.3% vs 11.1%, P<0.001).
The clinical efficiency of EO and EP regimens is similar to the first-line chemotherapy for extensive-stage SCLC in elderly patients. However, the tolerance of EO regimens is better than that in the EP regiments.
依托泊苷联合顺铂(EP)是广泛期小细胞肺癌(SCLC)最常用的一线治疗联合化疗方案,顺铂的副作用如恶心和呕吐会影响患者的生活质量。本研究旨在比较依托泊苷联合奥沙利铂(EO)与依托泊苷联合顺铂(EP)方案作为老年SCLC患者一线化疗的疗效和毒性。
71例未接受过抗肿瘤治疗的老年广泛期SCLC患者被随机分为两组,即EO组(依托泊苷:80mg/m² d1 - 5 + 奥沙利铂;130mg/m² d1;每21天重复)和EP组(依托泊苷:80mg/m² d1 - 5 + 顺铂;25mg/m² d1 - 3;每21天重复)。2个或更多周期后评估疗效和毒性。
EO组和EP组在缓解率(55.9%对54.3%,P = 0.894)、疾病控制率(82.4%对77.1%,P = 0.591)、中位无进展生存期(5.5个月对4.7个月,P = 0.638)和中位生存时间(10.5个月对9.1个月,P = 0.862)方面未观察到统计学差异。在毒性方面,EO组恶心/呕吐的发生率显著低于EP组(65.7%对97.2%,P = 0.001),但EO组1 - 2级神经毒性更显著(74.3%对11.1%,P < 0.001)。
EO方案和EP方案作为老年广泛期SCLC患者一线化疗的临床疗效相似。然而,EO方案的耐受性优于EP方案。