A comparative study on etoposide combined with lobaplatin or cisplatin in the first-line treatment of extensive-stage small cell lung cancer.

Purpose To compare the efficacy and safety of etoposide combined with lobaplatin or cisplatin in the first-line treatment of extensive-stage small cell lung cancer (SCLC). Methods A total of 98 extensive-stage SCLC patients treated at the Oncology Department from March 2015 to March 2017 were enrolled and divided into etoposide + lobaplatin group (EL group, n=49) and etoposide + cisplatin group (EP group, n=49) using a random number table. The clinical data of all patients were collected, and the short-term effective rate, changes in the levels of serum tumor markers carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and neurone specific enolase (NSE) before and after chemotherapy and adverse reactions were compared between the two groups. Moreover, the patients were followed up, and the overall survival (OS) and progression-free survival (PFS) were recorded. Results In EL group and EP group, the level of serum NSE significantly declined after treatment compared with that before treatment, but the levels of serum CEA and CYFRA21-1 were not significantly decreased after chemotherapy compared with those before chemotherapy. The incidence rate of leukopenia, erythropenia and thrombocytopenia was 71.4%, 44.9% and 40.8%, respectively, in EL group, and 85.7%, 30.6% and 24.5%, respectively, in EP group, and the degree I-II decline was more common in both groups. The proportion of gastrointestinal reactions was 14.3% and 59.2%, respectively, in EL group and EP group, with significant difference between the two groups. During follow-up, the 1-year OS was 59.2% (29/49) and 51.9% (25/49), respectively, and the 2-year OS was 26.5% (13/49) and 20.4% (10/49), respectively, in EL group and EP group. The survival curves of were plotted using the Kaplan-Meier method and log-rank test showed no statistically significant differences in the OS and PFS between the two groups. Conclusions The short-term efficacy of EL and EP regimens is equivalent in the first-line treatment of extensive-stage SCLC, both OS and PFS are similar, and the adverse reactions can be tolerated. The EL regimen produced mild gastrointestinal reactions, and is worthy of clinical popularization.