晚期非鳞非小细胞肺癌患者化疗疗效、缓解深度与无进展生存期的相关性

Correlation of Survival with Therapy Effect,Depth of Response in Patients with Advanced No-Squamous Non-Small Cell Lung Cancer Following Chemotherapy

[目的]探讨晚期非鳞非小细胞肺癌(NS-NSCLC)患者紫杉醇卡铂联合贝伐珠单抗(TCBev)方案化疗后治疗疗效、缓解深度(DpR)、肿瘤缩小速度分别与生存获益的关系。[方法]回顾性分析80例一线接受TCBev方案化疗的晚期NS-NSCLC患者的临床资料。治疗疗效按实体肿瘤疗效评价标准(RECIST)进行分类;按30%和60%的DpR将患者分为3个亚组;按中位DpR达到最大值时间(TTMD)将患者分为2个亚组。[结果] 38例(47.5%)患者达PR,37例(46.2%)SD,5例(6.3%)治疗后病灶增大。PR比SD患者的无进展生存期(PFS)时间长(9.6个月vs 6.9个月,P<0.001);DpR越大,PFS时间越长(10.6个月vs 8.2 vs 6.4个月,P<0.001);快速缩小(TTMD≤4.07个月)和缓慢缩小的PFS无统计学差异(6.9个月vs 8.2个月,P=0.524)。[结论]晚期NS-NSCLC患者接受TCBev方案化疗后,出现PR或者肿瘤缩小越明显时,其PFS时间相对越长,然而,肿瘤缩小的速度与PFS无明显相关性。

[Objective]To investigate the relationship of survival with therapy effect,depth of response(DpR)and tumor shrinkage rate in patients with advanced no-squamous non-small cell lung cancer(NSNSCLC)following chemotherapy.[Methods]The clinical data of 80 advanced NS-NSCLC patients who received paclitaxel carboplatin combined with bevacizumab(TCBev)regimen as first-line chemotherapy were retrospectively analyzed.The therapeutic effect was assessed according to the response evaluation criteria in solid tumor(RECIST).Patients were divided into three subgroups according to 30%and 60%DpR.Patients were divided into two subgroups according to median time to max DpR(TTMD).[Results]Among 80 patients,there were 38 cases(47.5%)with PR,37(46.2%)with SD,and 5(6.3%)with enlarged target lesions.The progression free survival(PFS)of PR patients was longer than that of SD patients(9.6 months vs 6.9 months,P<0.001).Patients with longer DpR had longer PFS(10.6 months vs8.2 vs 6.4 months,P<0.001).There was no significant difference in PFS between the rapid reduction(TTMD≤4.07 months)and slow reduction subgroups(6.9 months vs 8.2 months,P=0.524).[Conclusion]For patients with advanced NS-NSCLC treated with TCBev,the PFS is relatively long when therapy effect achieves PR or significant DpR,however,there is no significant correlation between tumor shrinkage rate and PFS.