Comparison of two second-line chemotherapy regimens for relapsed and refractory small cell lung cancer
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摘要: 目的 比较伊立替康联合顺铂化疗方案(IP)与紫杉醇联合顺铂化疗(TP)二线治疗方案对复发及难治性小细胞肺癌患者的安全性及疗效。 方法 将复发及难治性小细胞肺癌患者53例随机分为IP组(n=29)及TP组(n=24), 比较2组患者近远期疗效及不良反应。 结果 IP组及TP组的中位无进展生存时间(PFS)分别为4.5、3.5个月,中位总生存时间(OS)分别为10、9个月, 2组比较差异无统计学意义(P>0.05)。接受二线治疗前的一般健康状态(PS)评分是伊立替康或紫杉醇联合顺铂化疗的PFS的独立预后影响因素(P<0.05); 接受二线治疗前的PS评分、骨转移是生存时间(OS)的独立预后影响因素(P<0.05)。IP组迟发型腹泻的发生率高于TP组, TP组肢端麻木、关节酸痛的发生率高于IP组,差异有统计学意义(P<0.05)。 结论 伊立替康联合顺铂及紫杉醇联合顺铂方案疗效相当,安全性相近。Abstract: Objective To compare the safety and efficacy of irinotecan combined with cisplatin chemotherapy(IP)and paclitaxel combined with cisplatin chemotherapy(TP)in second-line treatments for patients with relapsed and refractory small cell lung cancer. Methods A total of 53 patients with relapsed and refractory small cell lung cancer were randomly divided into IP group(n=29)and TP group(n=24), and the short-term and long-term efficacy and adverse reactions of the two groups were compared. Results The median progression-free survival time(PFS)of the IP group and the TP group were 4.5 months and 3.5 months, and the median overall survival time(OS)was 10 months and 9 months, respectively, and there were no significant differences between the two groups(P>0.05). Physical status(PS)score before receiving second-line treatment was an independent prognostic factor of PFS with irinotecan or paclitaxel combined with cisplatin chemotherapy(P<0.05); PS score before receiving second-line treatment and bone metastasis were independent prognostic factors of survival time(OS). The incidence of delayed-onset diarrhea in the IP group was significantly higher than that in the TP group(P<0.05). The incidence rates of numbness and joint pain in the TP group were significantly higher than that in the IP group(P<0.05). Conclusion Cisplatin combined with irinotecan or paclitaxel have similar efficacy and similar safety.
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