晚期肺神经内分泌肿瘤伊立替康联合/不联合顺铂化疗的初步临床观察  

Clinical observation of irinotecan alone versus irinotecan combined with cisplatin in advanced pulmonary neuroendocrine tumors

作　　者：韩森[1] 马旭[1] 聂鋆[1] 戴玲[1] 胡维亨 陈筱玲[1] 张洁[1] 马向娟[1] 田广明[1] 吴頔[1] 龙皆然[1] 韩金娣[1] 王洋[1] 张自然 方健[1] HAN Sen;MA Xu;NIE Jun;DAI Ling;HU Wei-heng;CHEN Xiao-ling;ZHANG Jie;MA Xiang-juan;TIAN Guang-min;WU Di;LONG Jie-ran;HAN Jin-di;WANG Yang;ZHANG Zi-ran;FANG Jian(DepartmentⅡof Thoracic Oncology,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所胸部肿瘤内二科·恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中华肿瘤防治杂志》2021年第9期694-698,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(81772494);北京大学肿瘤医院科学研究基金(2020自主-27)。

摘　　要：目的探讨伊立替康(CPT-11)单药和联合顺铂(IP)方案化疗在局部晚期和转移性肺神经内分泌肿瘤(PNET)中的疗效及其不良反应。方法收集北京大学肿瘤医院2015-05-01-2018-04-30以CPT-11方案为基础进行化疗的局部晚期和转移性PNET患者的临床病历资料,回顾性分析21例CPT-U单药和47例IP联合方案在化疗疗效和不良反应方面的差异。采用护检验比较计数资料和各组组成差异。随访患者的无进展生存期(PFS)和总生存期(OS),Kaplan-Meier法分析PFS和OS。分别用Cox单因素和多因素回归方法分析PFS和OS的影响因素。结果68例PNET患者接受以CPT-11方案为基础的化疗,化疗的总体客观有效率(ORR)为10.3%(7/68),疾病控制率(DCR)为55.9%(38/68)。在不良反应方面,迟发性腹泻的发生率为39.7%(27/68),中性粒细胞减少的发生率为57.4%(39/68),肝功能异常的发生率为20.6%(14/68),恶心呕吐的发生率为47.1%(32/68)。CPT-11单药和IP方案化疗的ORR分别为9.5%和10.6%,DCR分别为42.9%和61.7%,差异均无统计学意义,均P>0.05。2种方案的PFS均为3.0个月;OS分别为5.0和8.0个月,但差异无统计学意义,P=0.557。Cox多因素回归分析提示,化疗周期数是OS的独立影响因素。IP方案在迟发性腹泻(46.8%)和中性粒细胞减少(63.8%)方面的发生率高于CPT-11单药(23.8%和42.9%),IP方案肝功能异常发生率(17.0%)低于CPT-11单药(8.6%),差异均无统计学意义,均P>0.05。二者恶心呕吐的不良反应发生率相近。结论在局部晚期和转移性PNET中IP方案化疗的ORR和DCR可能略高于CPT-11单药,OS有延长的趋势,但迟发性腹泻和中性粒细胞减少的不良反应可能增加。Objective To investigate the efficacy and adverse reactions of irinotecan(CPT-ll)alone versus irinotecan combined with cisplatin(IP)regimen in locally advanced and metastatic pulmonary neuroendocrine tumors(PNET).Methods Collect the clinical data of patients with locally advanced and metastatic PNET treated with CPT-11 based chemotherapy from May 1,2015 to April 30,2018 in the DepartmentⅡof Thoracic Oncology,Peking University Cancer Hospital.Retrospectively analyze the differences in efficacy and adverse reactions between CPT-11 regimen and IP regime n.Chi-square test was used to compare the counting data and the composition differences of each group.Progressive free survival(PFS)and total survival(OS)were followed up.PFS and OS were analyzed by Kaplan-Meier method.Single factor and Cox regression multifactor analysis were used to analyze the influencing factors of PFS and OS.Results A to­tal of 68 patients with PNET received CPT-11 based chemotherapy,of which 59(86.8%)were males,with a median age of 58 years.The overall objective response rate(ORR)and disease control rate(DCR)of chemotherapy were 10.3%(7/68)and 55.9%(38/68).The incidence of delayed diarrhea,neutropenia,liver dysfunction and nausea and vomiting were 39.7%(27/68),57.4%(39/68),20.6%(14/68)and 47.l%(32/68),respectively.The ORR of CPT-11 and IP regimen were 9.5%and 10.6%respectively,while DCR was 42.9%and 61.7%respectively.There was no significant difference between them.PFS of the two groups was 3.0 months;OS was 5.0 months and 8.0 months,respectively,but there was no significant difference(P=0.557).The number of chemotherapy cycles was an independent factor affecting OS.The incidence of delayed diarrhea and neutropenia in IP regimen was higher than that in CPT-11(46.8%vs 23.8%,63.8%vs 42.9%).The incidence of liver dysfunction in IP regimen was lower than than in CPT-11(17.0%vs 28.6%),but there was no significant difference.The incidence of adverse reactions in nausea and vomiting was similar between the two groups.Conclusions In locally advanced

关 键 词：肺神经内分泌肿瘤 伊立替康 化疗 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]