Combination therapy with carboplatin and paclitaxel for small cell lung cancer
Combination therapy with carboplatin and paclitaxel for small cell lung cancer
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DOI：
10.1016/j.resinv.2018.09.004
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Kobayashi, Kunihiko
中科院分区：
文献类型：
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作者：
Mouri, Atsuto;Yamaguchi, Ou;Kobayashi, Kunihiko
背景：虽然小细胞肺癌（SCLC）是一种侵袭性癌症，但复发后很少有有效的治疗选择。卡铂联合紫杉醇治疗SCLC.Methods的疗效和安全性的信息是有限的：从2007年4月至2016年10月，318例SCLC患者在我院接受化疗。回顾性分析铂类联合依托泊苷或伊立替康一线化疗后接受卡铂和紫杉醇治疗的患者的病历。目的是调查临床实践中对SCLC患者给予卡铂和紫杉醇方案的频率，并确定此类药物的反应率，无进展生存期（PFS）和耐受性。（7.5%）例患者（男性，n = 21;女性，n = 3;中位年龄，67岁;体能状态，0-1/>= 2，15/8例患者;局限性/广泛性疾病，6/15例患者;敏感/难治性复发，3/21例患者）用卡铂加紫杉醇治疗。由于间质性肺病（ILD）（n = 17）、放射性肺炎（n = 3）、联合姑息性放射治疗（n = 2）和存在其他癌症（n = 2），选择了该方案。有效率为33.3%，疾病控制率为62.5%。中位PFS和总生存期分别为4.1和8.7个月。观察到的3/4级血液学毒性包括中性粒细胞减少（54.2%）、贫血（4.2%）和血小板减少（8.3%）。除3级神经病变（n = 2）外，非血液学毒性均为轻度。结论：卡铂联合紫杉醇二线化疗治疗小细胞肺癌，尤其是合并间质性肺疾病的小细胞肺癌是有效可行的。(C)2018日本呼吸学会Elsevier B. V.出版，保留所有权利。
Background: Although small cell lung cancer (SCLC) is an aggressive cancer, few useful treatment options exist after relapse. Information concerning the efficacy and safety of carboplatin plus paclitaxel in patients with SCLC is limited.Methods: From April 2007 to October 2016, 318 patients with SCLC received chemotherapy at our institution. The medical records of patients treated with carboplatin and paclitaxel after first-line chemotherapy with platinum plus etoposide or irinotecan were retrospectively analyzed. The objectives were to investigate the frequency at which a carboplatin and paclitaxel regimen was administered to patients with SCLC in clinical practice, and to determine the response rate, progression-free survival (PFS), and tolerability of such agents.Results: A total of 24 (7.5%) patients (male, n = 21; female, n = 3; median age, 67 years; performance status, 0-1/>= 2, 15/8 patients; limited/extensive disease, 6/15 patients; sensitive/refractory relapse, 3/21 patients) were treated with carboplatin plus paclitaxel. This regimen was chosen due to interstitial lung disease (ILD) (n = 17), radiation pneumonitis (n = 3), combination with palliative radiation therapy (n = 2), and the presence of other cancers (n = 2). The response rate was 33.3%, and the disease control rate was 62.5%. The median PFS and overall survival were 4.1 and 8.7 months, respectively. Grade 3/4 hematologic toxicities observed included neutropenia (54.2%), anemia (4.2%), and thrombocytopenia (8.3%). With the exception of grade 3 neuropathies (n = 2), non-hematologic toxicities were mild. No patients experienced an acute exacerbation of ILD.Conclusion: A combination of carboplatin plus paclitaxel as second-line chemotherapy is effective and feasible in patients with SCLC, especially in those with ILD. (C) 2018 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.