The effect of small-molecular-weight heparin added to chemotherapy on survival in small-cell lung cancer - A retrospective analysis
The effect of small-molecular-weight heparin added to chemotherapy on survival in small-cell lung cancer - A retrospective analysis
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DOI：
10.4103/0019-509x.146784
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发表时间：
2014-07-01
影响因子：
1
通讯作者：
Coskun, H. S.
中科院分区：
文献类型：
--
作者：
Altinbas, M.;Dikilitas, M.;Coskun, H. S.
目的和背景：小细胞肺癌（SCLC）是一种化疗反应性肿瘤，与凝血系统的改变有关。在联合化疗（CT）中加入低分子肝素（LMWH）可提高生存率。本回顾性试验旨在确定使用达特帕林的持续时间是否对进展和生存有影响。材料与方法：回顾性分析67例SCLC患者接受顺铂-依托泊苷联合低分子肝素治疗的病历。结果：患者中位随访时间为11.3个月。结果：10.6%完全缓解，3.0%良好部分缓解，36.4%部分缓解，10.6%病情稳定，39.4%病情进展。40.3%的患者出现副作用。dalteparin的中位持续时间为6.1个月。根据患者服药时间将患者分为服药不足4个月（A组）、4-6个月（B组）和6个月以上（C组）3组。A组平均总生存期（OS）为6.5个月，B组为11.8个月，C组为14.6个月。B、C组的平均生存期长于A组，差异有统计学意义（P < 0.001）， B、C组间差异无统计学意义（P = 0.037）。平均无进展生存期（PFS）为9个月。结论：CT +低分子肝素至少4个月的耐受性良好，可能改善SCLC患者的PFS和OS。对于SCLC患者的治疗，CT加低分子肝素可能被认为是有效的未来治疗方法，必须进行进一步的多中心随机前瞻性临床试验来确定SCLC新的标准治疗方法。
AIMS AND BACKGROUND: Small cell lung cancer (SCLC) is a chemotherapy-responsive tumor and associated with alterations in the coagulation system. Addition of low-molecular-weight heparin (LMWH) to combination chemotherapy (CT) had resulted in increase in survival. The present retrospective trial was designed to determine whether the duration of dalteparin usage has an effect on progression and survival. MATERIALS AND METHODS: The medical records of 67 patients with SCLC who were given cisplatin-etoposide and concomitant LMWH (dalteparin) was evaluated retrospectively. RESULTS: Median follow-up of patients was 11.3 months. Outcome: 10.6% complete response, 3.0% good partial response, 36.4% partial response, 10.6% stable disease, and 39.4% progressive disease. Side-effects were seen in 40.3% of the patients. Median dalteparin duration was 6,1 months. According the duration of dalteparin patients were grouped in three: who took dalteparin less than 4 months (Group A), 4-6 months (Group B) and more than 6 months (Group C). Mean overall survival (OS) in Group A was 6.5 months, in Group B 11.8 months, and Group C 14.6 months. Mean OS in Group B and C were statistically significantly (P < 0.001) longer than Group A, between Group B and C there was not any significant difference (P = 0.037). Mean progression free survival (PFS) was 9 months. CONCLUSIONS: The CT plus LMWH minimum 4 months long is well-tolerable, and may improve PFS and OS in patients with SCLC. For treatment of patients with SCLC CT plus LMWH may be considered as effective future-therapy, and further multi-centre randomised prospective clinical trials must be done to determine the new standard treatment approach for SCLC.