Effects of different chemotherapies on prognosis and tumor markers in patients with small cell lung cancer / 国际肿瘤学杂志

ABSTRACT

Objective To explore the effect and safety of two chemotherapy regimens in the treatment of small cell lung cancer. Methods Ninety-eight patients with extensive small cell lung cancer admitted to Liuzhou People's Hospital of Guangxi Zhuang Autonomous Region from March 2013 to March 2016 were ran-domly divided into two groups by random number table method,49 of whom were treated with lobaplatin + eto-poside (EL group),and another 49 cases were treated with cisplatin + etoposide (EP group). The short-term efficacy,2-year survival rate and adverse reactions of the two groups were observed. The serum levels of gas-trin-releasing peptide precursor (ProGRP),neuron-specific enolase (NSE),Ki-67,vascular endothelial growth factor (VEGF)were compared between the two groups before and after treatment. Results The effec-tive rates of the EL group and the EP group were 48. 98％ (24 / 49)and 40. 82％(20 / 49)respectively,and the difference between the two groups was not statistically significant (χ2 = 0. 660,P = 0. 417). The 2-year sur-vival rates of patients in the EL group and the EP group were 17. 07％ and 11. 11％ respectively. The median survival time of the EL group was 17. 00 months,and that of the EP group was 15. 00 months. There was no significant difference between the two groups (χ2 = 1. 094,P = 0. 228). The serum level of ProGRP was (978. 4 ± 225. 7)ng/ L and (940. 2 ±237. 1)ng/ L,NSE was (43. 9 ±10. 3)ng/ ml and (41. 7 ±11. 6)ng/ ml, Ki-67 was (287. 5 ± 55. 3)pg/ ml and (279. 8 ± 62. 6)pg/ ml,and VEGF was (566. 8 ± 109. 4)pg/ ml and (538. 1 ±144. 0)pg/ ml in the EL and EP group before chemotherapy respectively,and there were no significant differences between the two groups (t = 0. 817,P = 0. 416;t = 0. 993,P = 0. 323;t = 0. 645,P = 0. 520;t =1. 111,P = 0. 269). The serum level of ProGRP was (167. 3 ± 68. 5)ng/ L and (180. 6 ± 62. 1)ng/ L,NSE was (17. 5 ±4. 8)ng/ ml,(19. 0 ±5. 3)ng/ ml,Ki-67 was (98. 0 ± 18. 6)pg/ ml and (101. 4 ± 20. 8)pg/ ml, VEGF was (430. 4 ±95. 8)pg/ ml and (442. 8 ±91. 0)pg/ ml in the EL and EP group after chemotherapy,and there was no significant difference between the two groups (t = - 1. 007,P = 0. 316;t = - 1. 468,P = 0. 145;t = - 0. 853,P = 0. 396;t = - 0. 657,P = 0. 513). The serum levels of ProGRP,NSE,Ki-67 and VEGF in EL group and EP group were significantly lower than those before chemotherapy (t = 24. 072,P < 0. 001;t =21. 694,P < 0. 001;t = 16. 263,P < 0. 001;t = 12. 459,P < 0. 001;t = 22. 736,P < 0. 001;t = 18. 931, P < 0. 001;t = 6. 566,P < 0. 001;t = 3. 916,P < 0. 001). During chemotherapy,the incidences of diarrhea and myelosuppression (≥grade 2)in the EL group [26. 53％ (13 / 49)and 61. 22％ (30 / 49)]were lower than those in the EP group [48. 98％ (24 / 49)and 81. 63％ (40 / 49)],and the differences were statistically significant (χ2 = 5. 254,P = 0. 022;χ2 = 5. 000,P = 0. 025). Conclusion Lobaplatin + etoposide is less toxic than cisplatin +etoposide in the treatment of small cell lung cancer,and adverse reactions of its is relatively slighter.