Clinical Comparative Analysis Of EP Sequencing With IP In The First-line Treatment Of Extensive-disease Small Cell Lung Cancer

Small cell lung cancer(SCLC)accounted for 20% to 25% of all lung cancer,60% to 70% of new cases is widely phase of the disease.And extensive SCLC high malignant degree,metastasis early,the majority of patients has spread to the blood lines,only one-third of the patients with pathological changes limited to the chest.SCLC is highly sensitive to chemotherapy,radiation therapy,the initial response rate is high,but easily happened secondary resistance,eventually died of tumor recurrene.The SCLC still to systemic chemotherapy as the main treatment,since the 1980 s,EP chemotherapy regimens(etoposide combined cisplatin)gradually replace CAV(cyclophosphamide + adriamycin + vincristine)scheme,and because of its survival advantage become standard line treatment plan of small cell lung cancer,EP project objective response rate of 60% to 70%,the median overall survival time for 9 to 11 months,2 years survival rate less of 5%.Most patients on chemotherapy to stop disease progress within six months,for how to improve the treatment of SCLC efficient,prolong patient survival time,reduce the resistance is becoming a hot spot of clinical research.In this paper,the EP schemes stability of the comparative analysis on the therapeutic effect of sequential chemotherapy,aims to explore the effective methods forimproving the prognosis of stage extensive SCLC.Objective:The retrospective analysis of effect and adverse reaction of etoposide combined with cisplatin(EP)sequencing with irinotecan combined with cisplatin(IP)in the first-line treatment of stable extensive-disease small cell lung cancer(ED-SCLC).Method:55 patients primarily diagnosed as ED-SCLC were involved in this study.All of the patients firstly received [EP] for 2 cycles effectively.From the third cycle,25 patients changed into [IP] plan,while the other 30 patients continued with [EP] plan.All the patients completed 4 cycles treatment or more.The evaluation of efficacy assessment and adverse effects in each 2 cycles.Results:All the 55 patients were evaluated,EP+IP groups: CR 0,PR 17,SD 6,PD2,ORR 68%,the EP groups:CR 0,PR 8,SD 17,PD 5,ORR 26.7%,The median PFS was 7.0 months in the EP+IP arm and 5.0 months in the EP arm,OS was16.0 months for the EP+IP arm and 12.0 months for the EP arm,the differences were statistically significant.(P<0.05).Two groups of patients with adverse reactions mainly for hematology toxicity and gastrointestinal reaction,EP+IP solutions group of hematology toxicity were lower than that in EP group,white blood cells and platelets to reduce the comparison of all showed significant difference(P<0.05),and the incidence of late-oneset diarrhea inEP+IP group is higher than EP group,but the most patients were at ?~?degree,which can be well tolerated.There's no chemotherapy related death were found.Conclusion:In the patients who primarily received 2 cycles [EP] effectively in the first-line treatment of small cell lung cancer,sequential IP plan will be more effective and safe than EP plan.