伊立替康联合紫杉醇二线治疗小细胞肺癌的回顾性分析

Retrospectively Analysis of the Efficacy and Toxicity of Irinotecan in Combination with Paclitaxel as Second-line Treatment in Small Cell Lung Cancer

目的回顾性分析伊立替康(CPT-11)联合紫杉醇(PTX)作为二线方案治疗小细胞肺癌(SCLC)的疗效和安全性。方法回顾性分析一线化疗后3~6月内复发后接受CPT-11联合PTX方案化疗的40例SCLC患者的临床资料。结果所有患者无进展生存时间(PFS)为65 d,其中进展(PD)者占10%(4/40),完全缓解(CR)者占0%(0/40),部分缓解(PR)者占37.5%(15/40),稳定(SD)者占52.5%(21/40),疾病控制率(DCR)90%,客观缓解率(ORR)37.5%。PFS的Cox多因素分析显示:PS评分、年龄、性别、吸烟史不是患者PFS的独立预后因素;神经元特异性烯醇化酶(NSE)数值下降提示患者预后好,差异有统计学意义(P<0.05);整体不良反应可耐受,发生III度骨髓抑制3例,发生III度腹泻1例。结论 CPT-11联合PTX作为二线治疗方案,获得了良好的疾病控制率和客观缓解率,副反应可耐受。

Objective As at present no standard second-line combination has been established for small cell lung cancer （SCLC）, in this paper the efficacy and safety of irinotecan in combination with paclitaxelas second-line treatment in Small Cell Lung Cancer was evaluated.Methods 40 patients who were diagnosed with SCLC,and accepted combined chemotherapy of CPT-11 and PTX due to relapse 3 to 6 months after first-line chemotherapy were analyzed retrospectively.Results Among the 40 patients, median progression free survival （PFS） was 65 days, PD was 10%（4/40）,CR was 0%（0/40）,PRwas 37.5%（15/40） ,SD was 52.5%（21/40）, DCR was 90% and ORR was 3？.5%.Multivariate analysis of ECOG demonstrates that PS,age,sex and smoke were not independent prognostic factors ;meanwhile the decrease of NSE showed better prognostic and the comparative differences showed statistical significance（ P〈0.05） ;Overall adverse reactions can be tolerated and the 3 cases of Ill myelotoxicity, 1 case of Ill diarrhose occurred.Conclusion Second-line treatment combined irinotecan and paclitaxel is effective and tolerable for refractory and relapsed small cell lung cancer.