替吉奥联合奈达铂对比多西他赛单药二线治疗晚期肺鳞癌的疗效观察

Comparison of S-1 plus nedaplatin versus docetaxel as second-line chemotherapy for advanced pulmonary squamous cell cancer

目的 探讨替吉奥（S-1）联合奈达铂与多西他赛单药二线治疗晚期肺鳞癌的疗效和安全性。方法 收集本院2012年12月至2014年12月一线含铂双药化疗方案治疗失败或缓解后再进展的晚期肺鳞癌患者共87例,其中43例接受S-1联合奈达铂治疗（观察组）,44例接受多西他赛单药治疗（对照组）,两方案均为21天1个周期。化疗2个周期后采用RECIST 1.1版标准评价客观疗效,采用美国国立癌症研究所毒性判定标准（NCI-CTCAE）4.0评价毒性反应,同时随访生存情况并评价两组生活质量的改善程度。结果 87例患者均可评价疗效。观察组和对照组的有效率分别为23.3%和18.2%,差异无统计学意义（P〉0.05）;观察组的疾病控制率为65.1%,高于对照组的40.9%,差异有统计学意义（P〈0.05）;两组中位无疾病进展生存期分别为3.6个月（95%CI：2.44~4.76个月）和2.9个月（95%CI：2.54~3.26个月）,差异有统计学意义（P〈0.05）;两组治疗后生活质量均有相应改善,差异无统计学意义（P〉0.05）。观察组主要的毒副反应为血液学毒性和消化道反应,对照组主要的毒副反应为血液学毒性和口腔黏膜炎,两组不良反应经对症治疗均可缓解。结论 S-1联合奈达铂二线治疗晚期肺鳞癌疗效更佳,不良反应可耐受。

Objective To compare the efficacy and safety of S-1 plus nedaplatin with docetaxel monotherapy in the treatment of second-fine chemotherapy for advanced pulmonary squamous cell cancer. Methods In this study, 87 patients with advanced pulmo- nary squamous carcinoma who had failed first-line platinum-based chemotherapy regimen were enrolled. Forty-three cases received S-1 combined with nedaplatin as observation group and 44 cases received docetaxel monotherapy as control group with every 21 days as one cycle. Response to chemotherapy was assessed in two cycles by RECIST criteria 1.1 and toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria 4. 0. The survival and score of quality of life was evaluated at the same time. Results Eight- y-seven patients could be evaluated for recent efficacy and adverse reaction. The response rates were 23.3% and 18.2% in observation group and control group without significant difference （P〉0. 05 ）. The disease control rate of observation group was 65.1%, higher than 40. 9% of control group with significant difference （P〈0. 05）. The median progression free survival （PFS） were 3.6 months（ 95%CI： 2. 44-4. 76 months） and 2. 9 months（ 95%CI： 2. 54-3. 26 months） in observation group and control group with significant difference （P 〈0. 05 ）. The score of quality of life in the observation group and control group were both improved, and the differences were not statis- tically significant（P〉0. 05）. The main adverse reaction of the observation group was hematology toxicity and gastrointestinal reaction and in control group was hematology toxicity and oral stomatitis. Adverse reactions could be alleviated by symptomatic treatment. Con- clusion S-1 combined with nedaplatin as the second-line treatment Of advanced pulmonary squamous cell carcinoma may have a better efficacy compared to docetaxel monotherapy, and its toxicities are tolerable.