中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2013年
9期
470-475
,共6页
于舒飞%王燕%胡兴胜%王宏羽%郝学志%许建萍%李峻岭%张湘茹%石远凯
于舒飛%王燕%鬍興勝%王宏羽%郝學誌%許建萍%李峻嶺%張湘茹%石遠凱
우서비%왕연%호흥성%왕굉우%학학지%허건평%리준령%장상여%석원개
肺肿瘤%伊立替康%铂类%复发
肺腫瘤%伊立替康%鉑類%複髮
폐종류%이립체강%박류%복발
Lung neoplasms%Irinotecan%Platinum%Relapsed
背景与目的对初治进展或复发的小细胞肺癌，目前尚无标准的二线方案，本研究旨在比较伊立替康联合奈达铂或联合顺铂治疗敏感复发或难治性小细胞肺癌的疗效和安全性。方法回顾了中国医学科学院肿瘤医院2009年4月-2012年4月诊治的1,140例小细胞肺癌患者，筛选二线接受伊立替康联合奈达铂（IN）或伊立替康联合顺铂（IC）方案化疗的患者进行分析。结果入组的54例患者中，中位无进展生存时间（progression free survival, PFS）为4.9个月，中位总生存时间（overall survival, OS）为13.3个月，IC组的PFS为4.3个月，IN组的PFS为5.4个月（P=0.465）。两组OS分别为13.3个月和14.3个月（P=0.704）。对生存时间的Cox多因素分析显示：二线治疗前的PS评分（P=0.003）、二线治疗前的转移部位个数（P=0.023）、接受化疗的周期数（P=0.003）是独立预后因素。整体的不良反应可耐受，IN组血液学毒性较重，IC组腹泻发生率较高，但均无统计学意义。结论伊立替康联合铂类是对于敏感复发和难治性小细胞肺癌有效且耐受性好的方案，伊立替康联合奈达铂在疗效及安全性方面都不劣于其联合顺铂。
揹景與目的對初治進展或複髮的小細胞肺癌，目前尚無標準的二線方案，本研究旨在比較伊立替康聯閤奈達鉑或聯閤順鉑治療敏感複髮或難治性小細胞肺癌的療效和安全性。方法迴顧瞭中國醫學科學院腫瘤醫院2009年4月-2012年4月診治的1,140例小細胞肺癌患者，篩選二線接受伊立替康聯閤奈達鉑（IN）或伊立替康聯閤順鉑（IC）方案化療的患者進行分析。結果入組的54例患者中，中位無進展生存時間（progression free survival, PFS）為4.9箇月，中位總生存時間（overall survival, OS）為13.3箇月，IC組的PFS為4.3箇月，IN組的PFS為5.4箇月（P=0.465）。兩組OS分彆為13.3箇月和14.3箇月（P=0.704）。對生存時間的Cox多因素分析顯示：二線治療前的PS評分（P=0.003）、二線治療前的轉移部位箇數（P=0.023）、接受化療的週期數（P=0.003）是獨立預後因素。整體的不良反應可耐受，IN組血液學毒性較重，IC組腹瀉髮生率較高，但均無統計學意義。結論伊立替康聯閤鉑類是對于敏感複髮和難治性小細胞肺癌有效且耐受性好的方案，伊立替康聯閤奈達鉑在療效及安全性方麵都不劣于其聯閤順鉑。
배경여목적대초치진전혹복발적소세포폐암，목전상무표준적이선방안，본연구지재비교이립체강연합내체박혹연합순박치료민감복발혹난치성소세포폐암적료효화안전성。방법회고료중국의학과학원종류의원2009년4월-2012년4월진치적1,140례소세포폐암환자，사선이선접수이립체강연합내체박（IN）혹이립체강연합순박（IC）방안화료적환자진행분석。결과입조적54례환자중，중위무진전생존시간（progression free survival, PFS）위4.9개월，중위총생존시간（overall survival, OS）위13.3개월，IC조적PFS위4.3개월，IN조적PFS위5.4개월（P=0.465）。량조OS분별위13.3개월화14.3개월（P=0.704）。대생존시간적Cox다인소분석현시：이선치료전적PS평분（P=0.003）、이선치료전적전이부위개수（P=0.023）、접수화료적주기수（P=0.003）시독립예후인소。정체적불량반응가내수，IN조혈액학독성교중，IC조복사발생솔교고，단균무통계학의의。결론이립체강연합박류시대우민감복발화난치성소세포폐암유효차내수성호적방안，이립체강연합내체박재료효급안전성방면도불렬우기연합순박。
Background and objective At present no standard second-line combination has been established for recurrent small cell lung cancer (SCLC). hTerefore we evaluate the effcacy and safety of irinotecan in combination with nedapla-tin/cisplatin against refractory or relapsed small cell lung cancer. Methods In this retrospective study, we analyzed the data of 1,140 patients who diagnosed small cell lung cancer at our hospital from April 2009 to April 2012. Of all the patients, 34 patients were treated with irinotecan and nedaplatin (irinotecan 60 mg/m2 on days 1, 8 nedaplatin 85 mg/m2 day 1, every 3 weeks) , and 20 patients were treated with irinotecan and cisplatin (irinotecan 60 mg/m2 on days 1, 8 cisplatin 75 mg/m2 day 1, every 3 weeks) as the second-line treatment. Prognostic factors of overall survival (OS) were estimated by Kaplan-Meier and Cox's Regression-proportional hazards model. Results Of all the 54 eligible patients, median progression free survival (PFS) was 4.9 months, and median OS was 13.3 months. Median PFS was 5.4 months for irinotecan plus nedaplatin (IN) and 4.9 months for irinotecan plus cisplatin (IC), respectively (P=0.465). Median OS was 14.3 months and 13.3 months, respectively (P=0.704). In multivariate analysis, ECOG PS, number of metastases and cycles of chemotherapy were independent prognostic factors. hTe toxicities were mild, while toxicity proifle was slightly different for each of the arms:hematologic toxicity was higher in IN group, and diarrhea was higher in IC group. Conclusion Irinotecan plus platinum is effective and tolerable for refractory and relapsed small cell lung cancer. Irinotecan plus nedaplatin is non-inferior to irinotecan plus cisplatin in terms of effcacy and safety.
