白蛋白结合型紫杉醇为基础的化疗方案治疗复发性小细胞肺癌的临床疗效

Clinical efficacy of albumin-bound paclitaxel-based chemotherapy regimen in the treatment of recurrent small cell lung cancer

目的观察白蛋白结合型紫杉醇为基础的化疗方案对复发性小细胞肺癌(SCLC)的临床疗效及不良反应。方法选择25例复发性SCLC患者,均接受白蛋白结合型紫杉醇为基础的方案化疗,给予白蛋白结合型紫杉醇130mg/m2,第1天和第8天静脉滴注,每21天为1个周期,化疗2个周期后或患者病情进展明显时复查计算机体层摄影(CT)评价疗效,观察其临床疗效及不良反应。结果25例复发性SCLC患者均可评价疗效,其中完全缓解(CR)0例,部分缓解(PR)6例,疾病稳定(SD)6例,疾病进展(PD)13例。总有效率(ORR)为24%,疾病控制率(DCR)为48%,中位无进展生存时间(PFS)为5.4个月。主要的不良反应为骨髓抑制、脱发、外周神经毒性、胃肠道反应、乏力等,以1~2级为主,均可耐受。化疗周期数为1的SCLC患者白细胞减少和中性粒细胞减少的发生率均为20.0%,分别低于化疗周期数≥2患者的75.0%和70.0%,差异均有统计学意义(P﹤0.05);单独用药SCLC患者乏力的发生率为15.4%,低于联合用药患者的58.3%,差异有统计学意义(P﹤0.05);美国东部肿瘤协作组(ECOG)评分﹤2分的SCLC患者肌肉关节疼痛的发生率为13.0%,低于ECOG评分≥2分患者的100%,差异有统计学意义(P﹤0.05)。结论白蛋白结合型紫杉醇为基础的化疗方案治疗复发性SCLC疗效肯定,不良反应可耐受。

Objective To observe the clinical efficacy and adverse reaction of albumin-bound paclitaxel-based chemotherapy regimen in the treatment of recurrent small cell lung cancer (SCLC). Method Twenty-five patients with recurrent SCLC who were enrolled in the study, and received the regimen of chemotherapy containing albumin-bound paclitaxel, which was administered weekly by intravenous injection at the dose of 130 mg/m^2 on day 1 and day 8, with 21 days as a cycle, the clinical efficacy and adverse reactions were evaluated by computer tomography (CT) reexamination every 2 cycles or when the patient’s condition progressed significantly. Result Among the 25 patients with evaluable recurrent SCLC, there were no patients achieving complete response (CR), while 6 cases had partial response (PR), 6 cases were with stable disease (SD) and progressive disease (PD) was observed in 13 cases. The overall response rate (ORR), disease control rate (DCR), and median progression-free survival (PFS) time were 24%, 48%, and 5.4 months, respectively. Major adverse reactions comprised bone marrow suppression, alopecia, peripheral nerve toxicity, gastrointestinal tract reaction, fatigue, etc., which were primarily grade 1-2, and could be tolerated. In SCLC patients with 1 cycle of chemotherapy, the incidence of leukopenia and neutropenia were both 20.0%, which were significantly lower compared to the 75.0% and 70.0% in those with ≥ 2 cycles of chemotherapy (P<0.05);besides, the incidence of fatigue among patients with monotherapy was 15.4%, and it was lower than the 53.8% in patients treated with combined medication, showing statistical significance (P<0.05);the incidence of myalgia was 13.0% in SCLC patients with Eastern Cooperative Oncology Group (ECOG)<2, and it was significantly lower compared to those with ECOG ≥ 2 at 100%(P<0.05). Conclusion albumin- bound paclitaxel-based chemotherapy is effective and tolerable in the treatment of recurrent SCLC.