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目的分析含依托泊苷方案二线治疗复发的广泛期小细胞肺癌疗效及不良反应。方法回顾性分析2006年2月2日~2015年2月2日75例在我院接受含依托泊苷方案二线治疗的广泛期小细胞肺癌患者。每1周期后根据WHO抗癌药物毒性反应评价标准进行化疗后不良反应分级,每2周期后按照实体瘤客观疗效评价标准(RECIST)1.1版评价治疗后的疗效,统计临床有效率和不良反应发生率。结果 75例患者中完全缓解(CR)1例(1.3%),部分缓解(PR)27例(36.0%),稳定(SD)25例(33.3%),进展(PD)22例(29.3%),总体客观缓解率(CR+PR)37.3%,疾病控制率(CR+PR+SD)70.7%.EP方案组的ORR为47.3%,高于单用依托泊苷方案组10.0%(χ2=11.19,P<0.05),中位无进展生存期4个月,中位总生存期为11.8个月。严重不良反应包括骨髓抑制3度以上11例(14.7%)、恶心呕吐3度以上6例(8.0%)、迟发性腹泻3度以上2例(2.7%),便秘1例(1.3%),无治疗相关性死亡。结论含依托泊苷方案二线化疗可以给一线治疗失败的复发的广泛期小细胞肺癌患者带来生存获益,EP方案组有较好的疾病缓解率,不良反应可耐受。
Objective To analyze the efficacy and adverse reactions of broad-spectrum small cell lung cancer with second-line etoposide-containing regimen. Methods A retrospective analysis of 75 patients with extensive stage of small cell lung cancer undergoing second-line therapy with etoposide in our hospital from February 2, 2006 to February 2, 2015 was retrospectively analyzed. Adverse reactions were classified according to WHO evaluation criteria of anticancer drug toxicity every 1 cycle. After 2 cycles, the curative effect was evaluated according to RECIST version 1.1, and the clinical effective rate and adverse reactions were statistically analyzed rate. Results The complete remission (CR) in 1 patient (1.3%), partial response (PR) in 27 patients (36.0%), stable (SD) in 25 patients (33.3%) and progression (PD) in 22 patients (29.3% , The overall objective response rate (CR + PR) was 37.3% and the disease control rate (CR + PR + SD) was 70.7% .The ORR of EP group was 47.3%, higher than that of the single etoposide group 10.0% (χ2 = 11.19 , P <0.05). The median progression-free survival was 4 months and the median overall survival was 11.8 months. Serious adverse reactions included 11 cases (14.7%) with myelosuppression more than 3 degrees, 6 cases (3.0%) with nausea and vomiting more than 3 degrees, 2 cases (2.7%) with delayed diarrhea more than 3 degrees and 1 case (1.3% No treatment-related deaths. Conclusions Second-line chemotherapy with etoposide can bring survival benefits to patients with recurrent broad-spectrum small cell lung cancer who have failed first-line treatment. EP regimen group has better disease response rate and adverse reaction tolerability.