作者
He Xing,Jie Zhang,Fangfang Ge,Xinhang Yu,Huimin Bian,Fu-Liang Zhang,Jian Fang
摘要
Among malignant tumors, lung cancer has the highest mortality rate. Small cell lung cancer (SCLC) is a kind of malignant lung cancer. Its doubling time is very fast. Patients are prone to drug resistance during treatment, and their condition often deteriorates rapidly after recurrence. Except for topotecan, there is a lack of effective second-line single-agent chemotherapy. This study aims to analysis the efficacy and safety of irinotecan (CPT-11) in the second-line treatment of refractory and relapsed SCLC.A total of 107 SCLC patients were collected from the Department of Oncology, Jilin Guowen Hospital, who were diagnosed from April 2012 to March 2020, relapsed within 6 months after first-line treatment, and received second-line chemotherapy with single-agent CPT-11. Follow-up until November 2020, calculate the patient's progression free survival (PFS) and overall survival (OS), and summarize the effects and adverse reactions of CPT-11 chemotherapy.The patient's median PFS was 3.8 (3.4-4.4) months, median OS was 8.1 (6.5-10.9) months, objective response rate (ORR) was 16.82% (18/107), and DCR was 55.14% (59/107). The incidence of grade 3-4 adverse reactions in patients was relatively low. Among them, neutropenia was 13.08%, delayed diarrhea was 7.48%, nausea and vomiting was 17.76%, and liver function impairment was 6.54%. The influencing factors of PFS in single-agent CPT-11 second-line chemotherapy were gender (P=0.001), NSE (P=0.029), and effusion (P=0.040). While the influencing factors of OS were NSE level only (P=0.033).For patients with refractory relapsed SCLC, CPT-11 single-agent second-line chemotherapy has a certain effect, is well tolerated, and is worthy of promotion. .【中文题目:伊立替康二线治疗难治性复发小细胞肺癌的疗效分析】 【中文摘要:背景与目的 肺癌死亡率在恶性肿瘤中高居首位,小细胞肺癌(small cell lung cancer, SCLC)是肺癌恶性程度最高的一种,其倍增时间短,患者在治疗过程中易发生迅速耐药,且复发后病情迅速恶化。目前除拓扑替康外,缺乏有效的二线单药化疗方案。本研究旨在探究伊立替康(irinotecan, CPT-11)二线单药治疗难治性复发SCLC的疗效及安全性。方法 收集吉林国文医院肿瘤内科2012年4月-2020年3月确诊的一线治疗后6个月内复发的经单药CPT-11二线化疗的SCLC患者107例,末次随访至2020年11月。记录患者的无进展生存时间(progression free survival, PFS)和总生存时间(overall survival, OS),观察单药CPT-11化疗效果以及不良反应发生情况。结果 患者的中位PFS为3.8(3.4-4.4)个月,中位OS为8.1(6.5-10.9)个月,客观缓解率(objective response rate, ORR)为16.82%(18/107),DCR为55.14%(59/107),3级-4级不良反应发生率较低,其中中性粒细胞减少为13.08%,迟发性腹泻为7.48%,恶心呕吐为17.76%,肝功能受损为6.54%。影响单药CPT-11二线化疗患者PFS的因素有性别(P=0.001)、NSE(P=0.029)以及积液状态(P=0.040),影响OS的因素仅为NSE水平(P=0.033)。结论 针对于难治性复发的SCLC患者,CPT-11单药二线化疗方案有一定疗效,耐受较好,值得推广应用。】 【中文关键词:肺肿瘤;难治性复发;伊立替康;耐药;疗效分析】.