101例难治性小细胞肺癌的二线治疗生存分析  

Analysis of Survival of 101 Cases with Refractory Recurrent Small Cell Lung Cancer with Second-line Treatment

作　　者：王文娴[1] 郑蕾[1] 宋正波[1] 张沂平[1] 

机构地区：[1]浙江中医药大学附属浙江省肿瘤医院,浙江省胸部肿瘤(肺食管)诊治技术研究重点实验室,浙江杭州310022

出　　处：《肿瘤学杂志》2015年第7期546-550,共5页Journal of Chinese Oncology

基　　金：浙江省自然科学基金(LY13H160024);卫生部医药卫生科技发展研究中心课题(W2012FZ134)

摘　　要：[目的]探讨含铂双药化疗和单药化疗用于难治复发小细胞肺癌（small cell lung cancer,SCLC）患者二线化疗的疗效及安全性。[方法 ]回顾性分析101例难治性SCLC患者二线治疗的疗效和生存情况,并采用Cox多因素分析模型进行预后相关因素的分析。[结果]单药和双药组有效率（response rate,RR）分别为2.9%和7.5%（P=0.208）,疾病控制率（disease control rate,DCR）分别为14.7%和59.7%（P〈0.001）,中位无进展生存期（progression-free survival,PFS）分别为1.23个月和2.77个月（P〈0.001）。两组中位总生存期（overall survival,OS）差异无统计学意义（5.40个月vs 5.93个月,P=0.988）。Ⅲ-Ⅳ度不良反应单药组比双药组发生率低（20.6%vs 52.2%,P=0.007）。多因素分析显示体能状况评分（performance status,PS）（HR=1.491,P=0.002）是PFS的独立影响因素。[结论 ]双药治疗可延长部分患者的PFS,但不良反应相对增加。[Purpose] To investigate the efficacy and safety of two-agent chemotherapy（combination chemotherapy） and single-agent chemotherapy（single chemotherapy） based on platinum as second-line chemotherapy in patients with refractory recurrent small cell lung cancer（SCLC）.[Methods] The efficacy and survival of 101 cases with refractory recurrent SCLC treated with second-line chemotherapy were analyzed,and prognostic factors were analyzed by COX proportional hazards model. [Results] In single chemotherapy and combination chemotherapy groups,the response rate（RR） were 2.9% and 7.5% respectively（P=0.208）;disease control rate,14.7%and 59.7%（P〈0.001）;median progression-free survival（PFS）,1.23 and 2.77 months（P〈0.001）,with significant difference. And there was no significant difference in median overall survival（OS） in the two groups（ 5.40 and 5.93 months,P=0.988）.The rate of toxicities grade Ⅲ-Ⅳ in single chemotherapy group was lower than that in combination chemotherapy group（20.6% vs52.2%,P=0.007）.The COX proportional hazards model analysis revealed that performance status score before second-line chemotherapy（0-1 vs 2;hazard ration=1.491,P=0.002） was an independent prognostic predictor of PFS after second-line chemotherapy. [Conclusion] Two-agent chemotherapy as a second-line chemotherapy regimen has an advantage of prolonging PFS,but increases toxicities.

关 键 词：癌 小细胞 肿瘤复发 二线治疗 生存期 肺肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]