The efficacy of amrubicin on central nervous system metastases originating from small-cell lung cancer: a case series of eight patients
The efficacy of amrubicin on central nervous system metastases originating from small-cell lung cancer: a case series of eight patients
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DOI：
10.1007/s10637-015-0233-7
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发表时间：
2015-06-01
影响因子：
3.4
通讯作者：
Yamamoto, Nobuyuki
中科院分区：
文献类型：
--
作者：
Miura, Satoru;Kaira, Kyoichi;Yamamoto, Nobuyuki
背景 由小细胞肺癌 (SCLC) 引起的中枢神经系统 (CNS) 转移无法治愈，因此是致命的。尽管此类转移通常采用化疗或放疗进行治疗，但它们对这些治疗措施的敏感性尚不清楚。氨柔比星似乎是治疗复发性 SCLC 的一种有前途的药物，但其对源自 SCLC 的 CNS 转移的有效性尚不清楚。方法2002年4月至2009年12月间，静冈县癌症中心收治110例伴有CNS转移的SCLC患者。其中，我们回顾性分析了连续 8 例因复发 SCLC 发生 CNS 转移且接受氨柔比星作为二线治疗的病例。结果 我们记录了 3 例敏感复发病例和 5 例难治性病例。氨柔比星的 CNS 缓解率为 50%（2 例部分缓解，2 例完全缓解；95% CI，21.5-78.5%），CNS 病变的疾病控制率为 87.5%（95% CI，52.9-97.8%）。所有敏感的复发患者均获得部分缓解。 CNS 转移的中位进展时间为 150.5 天（95% CI，9-171 天），从氨柔比星给药开始起的中位生存时间为 230.5 天（95% CI，89-619 天）。我们还报告了一名患者的髓内脊髓转移的放射学结果显着改善，并且在氨柔比星单药治疗（包括本病例系列）后症状得到缓解。结论 本研究结果表明，氨柔比星对源自 SCLC 的 CNS 转移患者具有活性。
Background Central nervous system (CNS) metastases caused by small-cell lung cancer (SCLC) are incurable and therefore fatal. Although such metastases are usually treated with chemotherapy or radiotherapy, their sensitivity to these treatment measures is unclear. Amrubicin appears to be a promising agent for relapsed SCLC, but its effectiveness in CNS metastases originating from SCLC is unknown. Methods Between April 2002 and December 2009, 110 SCLC patients with CNS metastasis were treated at Shizuoka Cancer Center. Of these, we retrospectively reviewed 8 consecutive cases with CNS metastases originating from relapsed SCLC that were treated with amrubicin as a second-line therapy. Results We recorded three sensitive relapses and five refractory cases. Amrubicin yielded a CNS response rate of 50 % (2 partial responses and 2 complete response; 95 % CI, 21.5-78.5 %) and the disease control rate for CNS lesions was 87.5 % (95 % CI, 52.9-97.8 %). All of the sensitive relapse patients achieved a partial response. The median time to progression for CNS metastases was 150.5 days (95 % CI, 9-171 days), and the median survival time from the start of amrubicin administration was 230.5 days (95 % CI, 89-619 days). We also report a dramatic improvement in one patient's radiological result of intramedullary spinal cord metastasis and alleviation of her symptoms following amrubicin monotherapy including this case series. Conclusions The results of this study suggest that amrubicin is active in patients with CNS metastases originating from SCLC.