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目的 比较自体外周血干细胞支持下高剂量化疗 (high dosechemotherapy ,HDCT)与常规剂量化疗 (conventionaldosechemotherapy ,CDCT)治疗小细胞肺癌 (SCLC)的疗效、生存期 ,并评价与高剂量化疗相关的毒性。方法 本试验观察了 2 7例经病理证实的SCLC患者 ,其中 1 3例为自体外周血干细胞支持下高剂量化疗 ,1 4例为常规剂量化疗。高剂量化疗组先行 1～ 3个周期IVP、CEP为主的诱导化疗 ,其剂量与常规化疗组相同 ,高剂量化疗方案CEP剂量为常规剂量的 3倍 ,干细胞动员用粒系集落刺激因子G CSF。高剂量化疗及常规化疗组 2疗程治疗结束后 ,除ⅢB、Ⅳ期外均给予手术或放疗。结果 高剂量化疗组诱导化疗缓解率为 76 .9% ,高剂量化疗缓解率为 1 0 0 % ,除 1例死亡外 ,其余患者生存期为 5 8～5 6 9d。常规剂量组第一疗程和第二疗程缓解率分别为 78.6 %和 85 .7% ,6例死亡 ,余生存期 90～ 430d。二组疗效经 χ2 检验 ,P >0 .0 5 ;生存期经时序检验 ,P <0 .0 0 1 ,有显著性差异。高剂量化疗的主要毒性反应为骨髓抑制 ,白细胞下降均为Ⅳ度 ,6 1 .5 %的患者出现Ⅳ度血小板下降 ,两项分别在干细胞回输后第 1 1天和第 1 4天恢复正常。无与治疗有关的死亡。结论 自体外周血干细胞支持下高剂量化疗治疗SCLC的缓解率、生存
Objective To compare the efficacy and survival of high-dose chemotherapy (HDCT) and conventional dosechemotherapy (CDCT) in the treatment of small cell lung cancer (SCLC) with autologous peripheral blood stem cells, and to evaluate the toxicity associated with high-dose chemotherapy. METHODS: Twenty-seven patients with pathologically confirmed SCLC were observed in this study. Among them, 13 patients received high-dose chemotherapy under the support of autologous peripheral blood stem cells and 14 received routine dose chemotherapy. The high-dose chemotherapy group received 1-3 cycles of induction chemotherapy with IVP and CEP predominantly. The dose was the same as that of the conventional chemotherapy group. The high-dose chemotherapy regimen was 3 times the conventional dose of CEP, and the granulocyte colony-stimulating factor G CSF was used for stem cell mobilization. . In the high-dose chemotherapy and conventional chemotherapy groups, surgery or radiotherapy was given in addition to the IIIB and IV phases after the completion of the 2 courses of treatment. Results The response rate of induction chemotherapy in high-dose chemotherapy group was 76.9%, and the response rate of high-dose chemotherapy was 100%. Except one death, the survival time of other patients was 58 to 59 days. The first course of treatment and the second course of remission rate in the conventional dose group were 78.6 % and 85.7% respectively, 6 cases died, and the remaining survival period was 90-430 days. The efficacy of the two groups was tested by χ2 test, P>0. 05; the survival time was tested by time series, P <0. 0 0 1, there was a significant difference. The main toxicities of high-dose chemotherapy were myelosuppression, leukopenia was grade IV, and 61.5% of patients had grade IV platelet drop, both of which returned to normal on day 1 and day 14 after stem cell reinfusion. . No treatment-related deaths. Conclusion Autologous peripheral blood stem cells support high-dose chemotherapy for the remission rate and survival of SCLC