[1]陈维领,李鑫,陈杼君,等.伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响[J].第三军医大学学报,2020,42(05):487-492.
 CHEN Weiling,LI Xin,CHEN Zhujun,et al.Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer[J].J Third Mil Med Univ,2020,42(05):487-492.
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伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第05期
页码:
487-492
栏目:
临床医学
出版日期:
2020-03-15

文章信息/Info

Title:
Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer
作者:
陈维领李鑫陈杼君刘攀唐春兰宫亮
陆军军医大学(第三军医大学)第一附属医院呼吸与危重症医学科
Author(s):
CHEN Weiling LI Xin CHEN Zhujun LIU Pan TANG Chunlan GONG Liang

Department of Respiratory and Critical Care Medicine, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
小细胞肺癌脑转移伊立替康治疗
Keywords:
small cell lung cancer brain metastasis irinotecan treatment
分类号:
R73-37; R734.2; R979.1
文献标志码:
A
摘要:

目的探讨伊立替康联合铂类对比依托泊苷联合铂类一线化疗对小细胞肺癌(small cell lung cancer,SCLC)患者脑转移的影响。方法回顾性分析2011年11月至2018年7月本院收治的126例基线无脑转移的SCLC患者,其中一线接受伊立替康方案化疗的84例(IP组),一线接受依托泊苷方案化疗的42例(EP组),比较两组一线治疗后的客观缓解率(ORR)、疾病控制率(DCR)、中位无进展生存期(PFS),以及中枢神经系统肿瘤(CNS)进展和非CNS进展的累积发生率。结果IP组和EP组的ORR分别为79.8%、76.2%,差异无统计学意义(P=0.645),DCR分别为89.3%、92.9%,差异无统计学意义(P=0.748)。IP组的中位PFS为7.500±0.779(5.974~9.026)个月,EP组的中位PFS为5.500±0.648(4.230~6.770)个月,两者差异有统计学意义(P=0.015)。与EP组比较,IP组局限期和广泛期小细胞肺癌患者的脑转移风险比分别为0.270,95%CI:0.096~0.760(P=0.013);0.914,95%CI:0.281~2.973(P=0.881)。治疗3个月后,IP组的局限期患者脑转移累积发病率均低于EP组,其1年的脑转移累计发生率分别为14.3%、31.8%。结论伊立替康联合铂类一线化疗局限期小细胞肺癌患者的脑转移时间较依托泊苷联合铂类一线化疗晚。

Abstract:

ObjectiveTo investigate the effects of platinum-based first-line chemotherapy combined with irinotecan versus with etoposide on brain metastasis of small cell lung cancer patients (SCLC). MethodsA retrospective analysis was carried out in 126 SCLC patients without brain metastases admitted to our hospital from November 2011 to July 2018 , including 84 patients receiving irinotecan chemotherapy in the first line (IP group), and 42 patients undergoing etoposide treatment in the first line (EP group), both based on platinum treatment. Objective response rate (ORR), disease control rate (DCR), and median progression-free survival (PFS), and cumulative incidence of central nervous system (CNS) and non-CNS progression after first-line treatment were compared between the 2 groups. ResultsFor the IP group and the EP group, the ORR were 79.8% and 76.2%, respectively (P=0.645), and the DCR was 89.3% and 92.9%, respectively (P=0.748). The median PFS was 7.500±0.779 (5.974~9.026) months in the IP group, and 5.500±0.648 (4.230~6.770) months in the EP group, and statistical difference was seen between them (P=0.015). Compared with the EP group, the risk ratios of brain metastasis in IP patients with limited and extensive stages of SCLC were 0.270 (95%CI: 0.096~0.760, P=0.013) and 0.914 (95%CI: 0.281~2.973, P=0.881). In 3 months after treatment, the cumulative incidence of brain metastases in patients with limited stage was lower in the IP group than the EP group, and the incidence at 1 year was 14.3% and 31.8%, respectively. ConclusionIP chemotherapy delays the brain metastasis of SCLC patients when compared with EP treatment.

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更新日期/Last Update: 2020-03-06