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目的:评估洛铂联合依托泊苷与顺铂联合依托泊苷治疗小细胞肺癌(smallcelllungcancer,SCLC)合并上腔静脉综合征(superior vena cava syndrome,SVCS)的近期疗效和毒性反应。方法:44例SCLC合并SVCS患者随机分为洛铂联合依托泊苷的洛铂组(23例)和顺铂联合依托泊苷的顺铂组(21例)。比较两组近期疗效和毒性反应。结果:洛铂组CR5例,PR10例;顺铂组CR6例,PR 9例,两组总有效率分别为65.2%和71.4%,差异无统计学意义(P>0.05)。两组毒性反应主要为骨髓抑制和消化道反应,血小板减少发生率无显著性差异(P>0.05);Ⅰ~Ⅱ度消化道反应发生率洛铂组和顺铂组分别为38.1%和17.4%,有显著性差异(P<0.05)。结论:洛铂联合依托泊苷与顺铂联合依托泊苷治疗SCLC合并SVCS疗效相当,洛铂组胃肠道反应较轻,且无需大量水化,更适合合并SVCS患者。
Objective: To evaluate the short-term curative effect and toxicity of small-cell lung cancer (SCLC) combined with superior vena cava syndrome (SVCS) with lobaplatin combined with etoposide and cisplatin in combination with etoposide. Methods: Forty-four patients with SCLC and SVCS were randomly divided into lobaplatin plus etoposide group (n = 23) and cisplatin plus etoposide cisplatin group (n = 21). Short-term efficacy and toxicity were compared between the two groups. Results: In CRP group, there were CR5 cases and PR10 cases; CR6 cases and PR9 cases in cisplatin group had a total effective rate of 65.2% and 71.4% respectively, with no significant difference (P> 0.05). There was no significant difference in the incidence of myelosuppression and digestive tract reaction and thrombocytopenia between the two groups (P> 0.05). The incidence of Ⅰ ~ Ⅱ digestive tract reaction was 38.1% and 17.4% , There was significant difference (P <0.05). CONCLUSION: Losoplatin combined with etoposide is more effective than cisplatin combined with etoposide in the treatment of SCLC with SVCS. Losopeptidase has less gastrointestinal reactions and does not require massive hydration, which is more suitable for patients with SVCS.