摘要目的：比较紫杉醇联合顺铂与伊立替康联合顺铂治疗小细胞肺癌的效果及安全性。方法选择一线治疗失败的小细胞肺癌患者170例，采用随机数字表法分为观察组和对照组，对照组给予紫杉醇联合顺铂二线化疗，观察组采用伊立替康联合顺铂二线化疗，比较两组化疗效果。结果观察组有效率为45.88％，对照组有效率为25．88％，组间差异有统计学意义（χ2＝7．389，P＜0．05）。观察组中位生存时间（10．32±2.41）个月，总生存时间（7．89±1．88）个月，中位无病生存时间（7．54±1．78）个月、卡氏评分（83．23±6．89）分、疼痛评分（2．37±1．07）分，对照组中位生存时间（7．45±1．03）个月、总生存时间（3．16±0．79）个月、中位无病生存时间（3．89±0．68）个月、卡氏评分（69．97±2．33）分、疼痛评分（4．81±2．13）分，组间差异均有统计学意义（t＝10．095、21．384、17．660、16．808、9．437，均P＜0．05）。观察组发生恶心呕吐5例、血小板减少3例、贫血1例、白细胞减少7例、乏力12例，对照组发生恶心呕吐16例、血小板减少11例、贫血6例、白细胞减少18例、乏力26例，组间差异均有统计学意义（χ2＝6．574、4．981、4．722、5．674、6．642，均P＜0．05）。结论以伊立替康为主的二线化疗方案应用在小细胞肺癌患者中能够提高治疗效果，不良反应轻微，可延长患者生存期，值得临床推广应用。

abstractsObjective To discuss the efficacy and safety of different second-line chemotherapies in small cell lung cancer chemotherapy.Methods 170 patients with small cell lung cancer who were failure to first -line treatment were chosen,they were randomly divided into observation group and control group.The control group was given paclitaxel plus cisplatin second-line chemotherapy,the observation group used the irinotecan joint cisplatin second-line chemotherapy.The effect of the two groups was recorded.Results The effective rate of the observation group was 45.88%,which of the control group was 25.88%,the difference between the two groups was statistically significant (χ2 =7.389,P<0.05).The median survival time,total survival time,median disease-free survival time, Karnofsky score,pain score of the observation group were (10.32 ±2.41)months,(7.89 ±1.88)months,(7.54 ± 1.78)months,(83.23 ±6.89)points,(2.37 ±1.07)points,which of the control group were (7.45 ±1.03)months, (3.16 ±0.79)months,(3.89 ±0.68)months,(69.97 ±2.33)points,(4.81 ±2.13)points,the differences between the two groups were statistically significant (t =10.095,21.384,17.660,21.384,17.660,all P<0.05).In the observation group,nausea and vomiting occurred in 5 cases,thrombocytopenia in 3 cases,anemia in 1 case,leukopenia in 7 cases,hypodynamia in 12 cases.In the control group,nausea and vomiting occurred in 16 cases,thrombocytopenia in 11 cases,6 cases of anemia,leukopenia in 18 patients,hypodynamia in 26 cases,the differences between the two groups were statistically significant(χ2 =6.574,4.981,4.722,4.981,4.722,all P <0.05).Conclusion The second-line chemotherapy regimens with irinotecan used in small cell lung cancer patients can improve the treatment effect,adverse reaction mild,prolong patients'survival,it is worth popularizing in clinical.