摘要
目的探究伊立替康与托泊替康对小细胞肺癌患者血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)及安全性的影响。方法回顾性分析2016年1月至2018年1月盐城市第二人民医院收治的57例老年小细胞肺癌患者,根据治疗药物不同分为托泊替康组(托泊替康治疗)、伊立替康组(伊立替康治疗)及依托泊苷组(依托泊苷治疗),各19例,21 d为1个周期,均连续治疗3个周期。比较3组临床疗效及用药安全性的差异,比较3组治疗前后肝功能指标的差异。结果3组疾病控制率及客观缓解率经比较差异无统计学意义(P>0.05),治疗后3组血清ALT、AST、总胆红素(TB)及直接胆红素(DB)水平均较治疗前降低,3组间血清ALT、AST、TB及DB水平比较差异无统计学意义(P>0.05)。伊立替康组患者延迟性腹泻发生率42.10%高于托泊替康组5.26%、依托泊苷组5.26%(P<0.05),托泊替康组白细胞水平降低发生率36.84%高于伊立替康组5.26%、依托泊苷组10.53%(P<0.05),3组血小板减少和贫血的发生率比较差异无统计学意义(P>0.05)。结论托泊替康与伊立替康、依托泊苷在治疗老年小细胞肺癌患者中能够取得相似的治疗效果,但临床上可以针对胃肠道功能不良患者采用托泊替康进行治疗,对于骨髓功能不良患者采取伊立替康进行治疗,根据患者实际情况为其开展不同的治疗方式。
Objective To investigate the effect of irinotecan and topotecan on the serum ast,ALT and safety in patients with small cell lung cancer.Methods A retrospective analysis was made of 57 cases of small cell lung cancer in Yancheng No.2 people's Hospital from January 2016 to January 2018.According to the different drugs,they were divided into three groups:topotecan group(treated with topotecan),irinotecan group(treated with irinotecan)and etoposide group(treated with etoposide),19 cases in each group,21 days as a cycle,all of which were treated for three consecutive cycles.The differences of clinical efficacy and drug safety between the three groups were compared,and the differences of liver function indexes between the three groups before and after treatment were compared.Results There was no significant difference in disease control rate and objective remission rate among the three groups(P>0.05).After treatment,the levels of serum ALT,AST,TB and DB in the three groups were lower than those before treatment.There was no significant difference in the levels of serum ALT,AST,TB and dB between the three groups(P>0.05).The incidence of delayed diarrhea in irinotecan group was 42.10%higher than that in topotecan group(5.26%)and etoposide group(5.26%),which was statistically significant(P<0.05).The incidence of white blood cell reduction in the topotecan group was 36.84%higher than that in the irinotecan group and 5.26%in the etoposide group,and 10.53%in the etoposide group(P<0.05).There was no significant difference in the incidence of thrombocytopenia and anemia among the three groups(P>0.05).Conclusion Topotecan,irinotecan,and etoposide can achieve similar therapeutic effects in the treatment of elderly patients with small cell lung cancer.However,it can be used clinically for patients with gastrointestinal dysfunction and to treat bone marrow dysfunction.Patients were treated with irinotecan,and different treatment methods were carried out for patients according to their actual conditions.
作者
邢陈
XING Chen(Yancheng Second People's Hospital,Yancheng,Jiangsu 224000,China)
出处
《大医生》
2019年第24期36-38,共3页
Doctor
关键词
托泊替康
伊立替康
小细胞肺癌
临床疗效
天冬氨酸转氨酶
丙氨酸转氨酶
topotecan
irinotecan
small cell lung cancer
clinical efficacy
aspartate aminotransferase
alanine aminotransferase
