托泊替康与伊立替康单药治疗老年小细胞肺癌的疗效观察

目的：观察托泊替康（TPT）和伊立替康（CPT－11）单药治疗老年小细胞肺癌的疗效及安全性。方法：50例老年小细胞肺癌患者，随机分为两组，分别给予TPT 1．2mg／m2静脉点滴第1～5天；CPT－1165mg／m2第1天和第8天静脉点滴化疗，3周一个化疗周期，共进行2～6周期。治疗开始后随访6～20个月，记录两组患者的白细胞计数、延迟性腹泻、肝功能、血小板计数、贫血等资料，评价近远期疗效，观察二者在疗效和安全性方面的差异。结果：两组患者在完全缓解（CR）、部分缓解（PR）、稳定（SD）、进展（PD）、客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）等方面无统计学差异（P＞0．05）；TPT组白细胞减少比例（64％）高于CPT－11组（32％），有统计学差异（P＝0．048），而CPT－11组延迟性腹泻发病率（64％）显著高于TPT组（20％），差异具有统计学意义（P＝0．004）。结论：托泊替康和伊立替康单药治疗老年小细胞肺癌的近远期疗效无差异，伊立替康组骨髓抑制轻于托泊替康组，但胃肠道不良反应比托泊替康重。

Observation on efficacy and adverse reactions of topotecan and irinotecan in treatment of elderly patients with small cell lung cancer

Objective:To observe the clinical efficacy and adverse reaction of topotecan (TPT)alone and irinote-can (CPT-1 1 )alone in treatment of elderly patients with small cell lung cancer (SCLC).Methods:50 elderly pa-tients with SCLC (28 male and 22 female)from Tumor Hospital of Shaanxi Province were enrolled in this study from June 2013 to November 2015.Patients were randomly divided into TPT group and CPT-11 group.TPT and CPT-11 was given at 1.2mg/m2 at day 1 to day 5 and 65mg/m2 at day one and day 8 respectively by injection for three weeks as a chemotherapy cycle for 2 to 6 cycles.White blood cell amount,platelet amount,liver function,incidence of de-layed diarrhea and anemia were collected during the follow-up lasting for 6 to 20 months.Results:There was no sig-nificant difference in efficacy such as the objective response rate,survival rate and survival time between topotecan and irinotecan (P>0.05 ).However,TPT patients showed statistically more severe leukocytopenia than CPT -1 1 (64%vs 32%,P=0.048).The incidence of delayed diarrhea in CPT-1 1 group was significantly higher than that in TPT group (64% vs 20%,P=0.004).Conclusion:Topotecan and irinotecan are the same effective in elderly pa-tients with small cell lung cancer.Topotecan causes severe bone marrow suppression while irinotecan often causes more often gastrointestinal adverse reaction and it should be concered during chemotherapy.