化疗诱导的白细胞减少症可预测小细胞肺癌生存  

Predictive value of chemotherapy-induced leukopenia for survival in small-cell lung cancer

作　　者：刘薇[1] 张翠翠[1] 李凯[1] 

机构地区：[1]天津医科大学附属肿瘤医院肺部肿瘤内科.天津市肿瘤防治重点实验室.天津市肺癌诊治中心,天津市300060

出　　处：《中国肿瘤临床》2013年第6期345-348,共4页Chinese Journal of Clinical Oncology

基　　金：天津市抗癌重大专项攻关计划项目(编号:12ZCDZSY15600)资助~~

摘　　要：目的:化疗是小细胞肺癌的标准治疗方式,而白细胞减少症是其常见的不良反应。本文研究旨在评估化疗诱导的白细胞减少症是否可作为预测小细胞肺癌患者疗效及生存的指标。方法:回顾性分析了445例接受4～10个周期标准化疗的小细胞肺癌患者的病例资料,按照WHO标准将白细胞减少症分为无白细胞减少症(0级)、轻度(1～2级)及重度白细胞减少症(3～4级)。主要研究终点为总生存时间。结果:化疗诱导的白细胞减少症与总生存时间之间明显相关,轻度白细胞减少的患者有较长的总生存期。轻度白细胞减少症的死亡危险比为0.687(95%CI:0.506～0.943),而重度白细胞减少症的死亡危险比为0.901(95%CI:0.669～1.214)。无白细胞减少的患者的中位生存时间为13个月、轻度与重度白细胞减少症的中位生存时间分别为17个月和14个月。结论:小细胞肺癌患者化疗过程中诱发的白细胞减少程度与患者生存有关,轻度白细胞减少的患者有较长的总生存时间。Objective： Leukopenia is a common side effect of chemotherapy, which is the standard treatment for small-cell lung cancer （SCLC）. This study determines whether chemotherapy-induced leukopenia could he a predictor of the curative effect and be associated with the survival of SCLC patients. Methods： Data from 445 SCLC patients who underwent standard chemotherapy from 4 to 10 cycles were retrospectively analyzed. Leukopenia during chemotherapy was graded according to the following classification by the World Health Organization： without （grade 0）, mild （grades 1 and 2）, and severe leukopenia （grades 3 and 4）. The endpoint of the main study was the overall survival （OS）. Results： Chemotherapy-induced leukopenia and OS time were found to be correlated. According to a multivariate Cox model with time-varying covariates, the hazard ratio of death was 0.687（from 0.506 to 0.943） and 0.90l （from 0.669 to 1.214） for patients with mild and severe leuk0Penia, respectively. The median survitval was 13 months for patients without leucopenia. By contrast, patients with mild and severe leukopenia had median survival of 17 and 14 months, respectively （P=-0.047）. Conclusions： Leukopenia during chemotherapy is associated with the survival of the SCLC patients. Mild leukopenia is strongly associated with a longer survival time.

关 键 词：小细胞肺癌 化疗 白细胞减少症 总生存时间 

分 类 号：R734.2[医药卫生—肿瘤]