| Jingjing Liu,Shuang Zhang,Lixia Ma,Chunjiao Wu,Changliang Yang,Xuerong Zuo,Ying Cheng. Efficacy analysis and multi-factor retrospective study of third-line chemotherapy in 82 Chinese patients with small cell lung cancer. Oncol Transl Med, 2015, 1: 26-31. |
| 82例中国小细胞肺癌患者三线治疗疗效和多因素预后分析 |
| Efficacy analysis and multi-factor retrospective study of third-line chemotherapy in 82 Chinese patients with small cell lung cancer |
| Received:December 31, 2014 Revised:December 31, 2014 |
| DOI：10.1007/s10330-014-0049-5 |
| 中文关键词: 小细胞肺癌; 三线治疗; 预后因素 |
| 英文关键词: small cell lung cancer; third-line chemotherapy; prognostic factors |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Jingjing Liu | Jilin Provincial Cancer Hospital, Changchun 130012, China | jingjingstone@126.com | | Shuang Zhang | Jilin Provincial Cancer Hospital, Changchun 130012, China | zhangshuangphy@126.com | | Lixia Ma | Jilin Provincial Cancer Hospital, Changchun 130012, China | jl.cheng@163.com | | Chunjiao Wu | Jilin Provincial Cancer Hospital, Changchun 130012, China | jl.cheng@163.com | | Changliang Yang | Jilin Provincial Cancer Hospital, Changchun 130012, China | jl.cheng@163.com | | Xuerong Zuo | Jilin Provincial Cancer Hospital, Changchun 130012, China | jl.cheng@163.com | | Ying Cheng* | Jilin Provincial Cancer Hospital, Changchun 130012, China | jl.cheng@163.com |
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| 中文摘要: |
| 目的：小细胞肺癌（Small cell lung cancer, SCLC）三线治疗的方案尚无明确推荐，是否获益亦不明确，且目前尚无中国SCLC患者三线治疗的相关报道。因此我们回顾性分析了中国SCLC患者三线治疗的疗效、安全性和预后因素。
方法：回顾性分析接受三线治疗的SCLC患者的临床资料，分析三线治疗的疗效、生存情况和安全性。
结果：2007年至2013年期间共82例SCLC患者接受过三线治疗，确诊时的中位年龄为55岁；男性62例（75.6%），女性20例（24.4%）；美国退伍军人肺癌研究组(VALG)分期：局限期/广泛期：44/38。三线治疗时55例（67.1%）ECOG PS 0-1。所有病人接受三线治疗的ORR为15.9%, 中位OS（OS-3）和中位PFS（PFS-3）分别为5.6个月和3.0个月。单因素分析显示，PFS-3与三线治疗时的ECOG PS评分（P=0.005）、二线治疗疗效（P=0.002）、三线治疗疗效（P<0.001），PFS-2分类（P=0.026）显著相关。OS-3与三线治疗时的ECOG PS评分（P<0.001）、三线治疗疗效（P=0.033）、PFS-1（P=0.044）和PFS-2（P=0.007）显著相关。多因素分析显示三线治疗的ECOG PS评分（P=0.008）和三线治疗疗效（P=0.046）是PFS-3的独立预后因素；三线治疗的ECOG PS（P=0.007）和PFS-2（P<0.001）是OS-3的独立预后因素。
结论：临床中只有少部分SCLC患者接受三线治疗，ECOG PS 0-1 和 PFS-2 >3个月的SCLC患者在三线化疗中更能获益，对于此类患者应积极给予三线治疗。 |
| 英文摘要: |
| Objective: As there is currently no clear recommendation for third-line chemotherapy for small cell lung cancer (SCLC), its efficacy is unknown. To date, there have rarely been reports of Chinese patients with
SCLC who received third-line chemotherapy. Therefore, we investigated the efficacy, safety, and prognostic factors of Chinese patients with SCLC treated with third-line chemotherapy.
Methods: A retrospective analysis of patients with SCLC who received third-line chemotherapy was performed.
Results: Between 2007 and 2013, 82 patients [62 men (75.6%), 20 women (24.4%); median age at the time of diagnosis, 55 years] received third-line chemotherapy at our center. Of these patients, 44 had limited-stage disease and 38 had extensive-stage disease. On third-line chemotherapy, 55 (67.1%) patients had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–1, objective response rate of 15.9%, and median overall survival after third-line chemotherapy (OS-3) and median progression-free survival after third-line chemotherapy (PFS-3) of 5.6 months and 3.0 months, respectively. On univariate analysis, PFS-3 was significantly related with ECOG PS (P = 0.005), response to second-line chemotherapy (P = 0.002), response to third-line chemotherapy (P < 0.001), and PFS after second-line chemotherapy (P = 0.026). OS-3 was significantly related with ECOG PS (P < 0.001), response to thirdline chemotherapy (P = 0.033), PFS after first-line therapy (P = 0.044), and PFS after second-line therapy (PFS-2) (P = 0.007). On multivariate analysis, ECOG PS (P = 0.008) and response to third-line chemotherapy (P = 0.046) were independent prognostic factors for PFS-3, while ECOG PS (P = 0.007) and PFS-2 (P < 0.001) were independent prognostic factors for OS-3.
Conclusion: Few patients with SCLC receive third-line chemotherapy. Our findings suggest that patients with an ECOG PS 0–1 and PFS-2 for >3 months will be benefit from third-line chemotherapy, which should be actively offered to them. |
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