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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年05期

页码:

415-419424

栏目:

临床医学

出版日期:

2018-09-20

文章信息/Info

Title:

Comparison of the efficacy and toxicity between the IP regimen and the CAO regimen in the second line treatment for recurrent small cell lung cancer

作者:

张姝阳; 张家丽; 赵 宁; 董一楠; 张新伟

天津医科大学肿瘤医院生物治疗科，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心，天津市肿瘤免疫与生物治疗重点实验室，天津 300060

Author(s):

ZHANG Shu-yang ;  ZHANG Jia-li;  ZHAO Ning;  DONG Yi-nan;  ZHANG Xin-wei

Department of Biotherapy, Cancer Institute and Hospital, Tianjin Medical University, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin 300060,China

关键词:

小细胞肺癌; 复发; 二线治疗; 伊立替康

Keywords:

small cell lung cancer; relapse;  second-line treatment;  irinotecan

分类号:

R734.2

DOI:

-

文献标志码:

A

摘要:

目的：分析IP（伊立替康联合奈达铂）及CAO（环磷酰胺、表柔比星、长春瑞滨）方案在二线治疗中的疗效及安全性，旨在为临床选择二线治疗方案提供潜在可能。方法：回顾性分析二线治疗使用IP或CAO方案化疗的小细胞肺癌患者56例，评估两种方案的疗效及安全性。结果：入组的56例患者中46例患者可评价近期疗效，IP组客观缓解率为24.1%，CAO组为23.5%（P =1.000），IP组疾病控制率为58.6%，CAO组为29.4%（P =0.056）；IP组中位PFS（无进展生存期）为3.0个月，CAO组中位PFS为2.6个月，两组中位OS（总生存期）分别为6.8个月和7.1个月，均无统计学差异。对生存时间进行Cox分析显示接受二线治疗前PS评分（P =0.032）、二线治疗前接受胸部放疗（P =0.034）是接受二线治疗总生存时间的独立预后因素。对两组的安全性分析显示IP组的腹泻发生率高于CAO组（P =0.034）。结论：在复发小细胞肺癌二线治疗中，IP方案与CAO方案效果相当，IP方案腹泻发生率较高。

Abstract:

Objective: To evaluate the efficacy and safety of IP (irinotecan plus nedaplatin) and CAO (cyclophosphamide combined with epirubicin and vinorelbine) in the second-line treatment of small cell lung cancer. Methods: This study retrospectively analyzed 56 patients who were diagnosed with small cell lung cancer. All patients were treated with IP or CAO as second-line regimes. The efficacy and the safety of the two groups were evaluated. Results: Of the 56 patients, 46 patients were eligible to evaluate the short-term efficacy. In the IP group and CAO group, the ORR were 24.1% and 23.5%, and the DCR were 58.6% and 29.4%, respectively. There was no statistically significant difference (P =1.000；P =0.056). The median PFS were 3.0 months in the IP group and 2.6 months in the CAO group. The median OS was 6.8 months and 7.1 months, respectively. No significant difference was observed between the two groups. Multivariate Cox analysis showed that the thoracic radiotherapy (P =0.034) and ECOG PS (P =0.032) were independent prognostic factors. In the assessment of toxicity, the diarrhea incidence was higher in IP group (P =0.034). Conclusion: In the second-line treatment of recurrent small cell lung cancer, IP regimen does not show superiority to CAO regimen, but the incidence of diarrhea of IP regimen is higher.

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备注/Memo

备注/Memo:

基金项目 国家科技支撑计划资助项目(2015BAI12B12)；国家自然科学基金资助项目(81272221) 作者简介 张姝阳 (1991-)，女，硕士在读，研究方向:肿瘤学；通信作者：张新伟,E-mail: zhangxinwei@tjmuch.com 。

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更新日期/Last Update: 2018-09-30