Comparison of Efifcacy and Safety of Different Therapeutic Regimens as Second-line Treatment for Small Cell Lung Cancer
10.3779/j.issn.1009-3419.2015.05.05
- VernacularTitle:二线不同化疗方案治疗小细胞肺癌的疗效和安全性比较
- Author:
LI ZHIHUA
1
,
2
;
LIU XIAOQING
;
LI JIANJIE
;
GAO HONGJUN
;
TANG CHUANHAO
;
LI XIAOYAN
;
GUO WANFENG
;
QIN HAIFENG
;
WANG WEIXIA
;
QU LILI
;
CHEN JIAN
Author Information
1. 100071 北京，解放军第307医院肺部肿瘤内科
2. 100088北京，解放军第二炮兵总医院肿瘤科
- Keywords:
Lung neoplasms;
Second-line chemotherapy;
Response Rate;
Survival;
Safety
- From:
Chinese Journal of Lung Cancer
2015;(5):280-288
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Small-cell lung cancer (SCLC) is an aggressive disease for which the mainstay of treatment is cytotoxic chemotherapy. Despite good initial responses most patients will relapse or progress atfer the ifrst-line therapy. hTe evidence of a beneift from second-line chemotherapy is limited in patients with relapsed/advanced SCLC. Some drugs are recommended by guidelines, but more regimens are formulated based on experience in clinical. So we conducted this retrospective study in order to compare the effcacy and safety of different second-line treatment regimens. Methods We totally analyzed 309 patients received second-line treatment in our retrospective study. 157 patients received best supportive care (BSC), and the rest 152 patients received second-line chemotherapy. hTe Kaplan-Meier method survival curves and Log-rank test were used to analysis the differences among different groups. hTe endpoints were objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). Results Patients administered second-line chemotherapy lived signiifcantly longer, with a total OS from ifrst-line therapy of 11.5 mo compared to 6.0 mo in patients with best supportive care alone (P<0.001), and the ORR, DCR, PFS and OS of the former (including the sensitive dis-ease and resistance/refractory disease patients) were obviously better than that of the latter. hTe ORR and DCR of the patients who received second-line chemotherapy is 39.5%and 59.2%, respectively. hTe median PFS and OS from second-line chemo-therapy were 3.3 mo and 5.3 mo. hTe patients who received second-line chemotherapy were divided by types of second-line regimens. hTe sensitive disease patients were from group A (VP-16-based rechallenge) and group B1 (CPT-11-based regimen). hTe ORR of the two groups were 48.6%and 35.3%, and the DCR were 68.6%and 58.8%, respectively. hTere was no statistically signiifcant difference (P=0.264;P=0.400). hTe median PFS from second-line chemotherapy of the two groups were 4.0 mo and 3.0 mo, and the second-line median OS were 6.5 mo and 4.5 mo. hTere was no statistic difference (P=0.432;P=0.508). hTe resistance/refractory disease patients were divided into group B2 (CPT-11-based regimen), group C (PTX/DXL-based regi-men) and group D (TPT-based regimen). hTere was no statistic difference in second-line ORR, DCR and median PFS among the three groups (P value is 0.521, 0.528 and 0.775, respectively);hTe median OS from second-line chemotherapy of the group D is longer than that of group B2 and group C, with statistical difference (P=0.043;P=0.030). hTe differences of grade III-IV hematologic toxicities among the four subgroups were not statistically different. hTe incidence of diarrhea in non-hematologic toxicities in patients who received irinotecan as second-line chemotherapy was higher than other three subgroups (P=0.029). Conclusion Patients who progressed atfer the completion of ifrst-line chemotherapy can gain survival beneift. hTe response and the PFS of the different second-line chemotherapies were similar. hTe patients who received the TPT-based regimen may gain longer overall survival than other resistance/refractory disease patients.
