Objective As there is currently no clear recommendation for third-line chemotherapy for small cell lung cancer （SCLC）, its efficacy is unknown. To date, there have rarely been reports of Chinese patients with SCLC w...Objective As there is currently no clear recommendation for third-line chemotherapy for small cell lung cancer （SCLC）, its efficacy is unknown. To date, there have rarely been reports of Chinese patients with SCLC who received third-line chemotherapy. Therefore, we investigated the efficacy, safety, and prognostic factors of Chinese patients with SCLC treated with third-line chemotherapy. Methods A retrospective analysis of patients with SCLC who received third-line chemotherapy was performed. Results Between 2007 and 2013, 62 patients [62 men （75.6%）, 20 women （24.4%）; median age at the time of diagnosis, 55 years] received third-line chemotherapy at our center. Of these patients, 44 had limited-stage disease and 38 had extensive-stage disease. On third-line chemotherapy, 55 （67.1%） patients had an Eastern Cooperative Oncology Group performance status （ECOG PS） of 0-1, objective response rate of 15.9%, and median overall survival after third-line chemotherapy （OS-3） and median progres- sion-free survival after third-line chemotherapy （PFS-3） of 5.6 months and 3.0 months, respectively. On univariate analysis, PFS-3 was significantly related with ECOG PS （P = 0.005）, response to second-line chemotherapy （P = 0.002）, response to third-line chemotherapy （P 〈 0.001）, and PFS after second-line chemotherapy （P = 0.026）. OS-3 was significantly related with ECOG PS （P 〈 0.001）, response to third-line chemotherapy （P = 0.033）, PFS after first-line therapy （P = 0.044）, and PFS after second-line therapy （PFS-2） （P = 0.007）. On multivariate analysis, ECOG PS （P = 0.008） and response to third-line chemotherapy （P = 0.046） were independent prognostic factors for PFS-3, while ECOG PS （P = 0.007） and PFS-2 （P 〈 0.001） were independent prognostic factors for OS-3. Conclusion Few patients with SCLC receive third-line chemotherapy. Our findings suggest that patients with an ECOG PS 0-1 and PFS-2 for 〉3 months will be benefit from third-line chemotherapy, which should be actively offered to them.展开更多
基金Supported by grants from the Jilin Health and Family Planning Commission Scientific Research Project(No.2014Z014)the "12th Five" Project of National Key Subject of New Drug Innovation(No.2013ZX09104001)
文摘Objective As there is currently no clear recommendation for third-line chemotherapy for small cell lung cancer （SCLC）, its efficacy is unknown. To date, there have rarely been reports of Chinese patients with SCLC who received third-line chemotherapy. Therefore, we investigated the efficacy, safety, and prognostic factors of Chinese patients with SCLC treated with third-line chemotherapy. Methods A retrospective analysis of patients with SCLC who received third-line chemotherapy was performed. Results Between 2007 and 2013, 62 patients [62 men （75.6%）, 20 women （24.4%）; median age at the time of diagnosis, 55 years] received third-line chemotherapy at our center. Of these patients, 44 had limited-stage disease and 38 had extensive-stage disease. On third-line chemotherapy, 55 （67.1%） patients had an Eastern Cooperative Oncology Group performance status （ECOG PS） of 0-1, objective response rate of 15.9%, and median overall survival after third-line chemotherapy （OS-3） and median progres- sion-free survival after third-line chemotherapy （PFS-3） of 5.6 months and 3.0 months, respectively. On univariate analysis, PFS-3 was significantly related with ECOG PS （P = 0.005）, response to second-line chemotherapy （P = 0.002）, response to third-line chemotherapy （P 〈 0.001）, and PFS after second-line chemotherapy （P = 0.026）. OS-3 was significantly related with ECOG PS （P 〈 0.001）, response to third-line chemotherapy （P = 0.033）, PFS after first-line therapy （P = 0.044）, and PFS after second-line therapy （PFS-2） （P = 0.007）. On multivariate analysis, ECOG PS （P = 0.008） and response to third-line chemotherapy （P = 0.046） were independent prognostic factors for PFS-3, while ECOG PS （P = 0.007） and PFS-2 （P 〈 0.001） were independent prognostic factors for OS-3. Conclusion Few patients with SCLC receive third-line chemotherapy. Our findings suggest that patients with an ECOG PS 0-1 and PFS-2 for 〉3 months will be benefit from third-line chemotherapy, which should be actively offered to them.
