替吉奥联合洛铂对比多西他赛联合洛铂二线治疗晚期肺鳞癌疗效和安全性的回顾性分析
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摘要
目的比较替吉奥与多西他赛分别联合洛铂治疗晚期肺鳞癌的临床疗效和安全性。方法选取我院2015年6月～2018年2月一线化疗后进展的晚期肺鳞癌患者79例,其中40例接受替吉奥联合洛铂化疗(实验组),39例接受多西他赛联合洛铂化疗(对照组),两组方案均为21天一周期,两组病人接受化疗,直至疾病进展或不良反应不可耐受,比较两组患者的临床疗效和不良反应,并随访疾病无进展生存期(PFS)。结果实验组和对照组有效率(RR)分别为22.5%和15.4%,无统计学差异(P=0.568),疾病控制率(DCR)分别为67.5%和41%,差异有统计学意义(P=0.024)。实验组和对照组中位PFS分别为3.8个月(95%CI:3.18～4.41个月)和2.6个月(95%CI:2.3～2.9个月),差异有统计学意义(P=0.048)。对照组主要不良反应为粒细胞减少及乏力,其中III～IV级粒细胞减少及乏力发生率分别为28.2%和23.1%,较实验组差异有统计学(P=0.048和P=0.025)意义。化疗后两组在躯体功能、角色功能、疼痛、总体生活质量方面均有改善,实验组化疗后在社会功能、情绪功能方面评分增高,恶心呕吐、食欲减退加重,对照组化疗后疲倦、呼吸困难较前加重,两组化疗后比较,疲倦症状对照组较实验组明显,总体生活质量实验组较对照组提高,差异均具有统计学意义。结论替吉奥联合洛铂二线治疗晚期肺鳞癌的疗效较多西他赛联合洛铂更佳,生活质量提高,不良反应可耐受。
Objective To compare the clinical efficacy and security of S-1 plus lobaplatin with docetaxel plus lobaplatin for patients with advanced lung squamous cell carcinoma.Method A total of 79 patients with advanced lung squamous cell carcinoma who progressed after first-line chemotherapy from June 2015 to February 2018 in our hospital were collected.Among them,40 patients received chemotherapy with S-1 and lobaplatin(experimental group),and 39 patients received docetaxeland lobaplatin with every 21 days as one cycle.After 2 cycles of chemotherapy,the efficacy and quality of life of the two groups were compared,adverse reactions were observed,and progression survival(PFS) was followed.Result The response rate(RR) was 22.5% for the experimental group and 15.4% for the control group. There was no statistical difference(P=0.568).The disease control rate(DCR)was 67.5% and 41%, respectively.The difference was statistically significant(P=0.024).The median PFS for the experimental and control groups was 3.8 months(95% CI: 3.18-4.41 months) and 2.6 months(95% CI: 2.3-2.9 months),respectively,with a statistically significant difference(P=0.048).The main adverse reactions in the control group were granulocytopenia and fatigue,and the incidence of III-IV granulocytopenia and fatigue was 28.2% and23.1%, respectively,which was statistically different from the experimental group(P=0.048 and P=0.025).After chemotherapy,both groups improved in terms of physical function,role function, pain,and overall quality of life.In the experimental group,the social function and emotional function scores increased after chemotherapy,nausea,vomiting,and loss of appetite aggravated.The control group suffered from fatigue and dyspnea after chemotherapy.Compared with the data of two groups after chemotherapy,the fatigue symptoms in the control group was more obvious than the experimental group,and the overall quality of life of experimental group was higher than the control group,and the differences were statistically significant.Conclusion The efficacy of S-1 combined with lobaplatin in the secondlinetreatment of advanced lung squamous cell carcinoma is better than that of docetaxel combined with lobaplatin, the quality of life is improved, and the adverse reactions are tolerable.
Objective To compare the clinical efficacy and security of S-1 plus lobaplatin with docetaxel plus lobaplatin for patients with advanced lung squamous cell carcinoma.Method A total of 79 patients with advanced lung squamous cell carcinoma who progressed after first-line chemotherapy from June 2015 to February 2018 in our hospital were collected.Among them,40 patients received chemotherapy with S-1 and lobaplatin(experimental group),and 39 patients received docetaxeland lobaplatin with every 21 days as one cycle.After 2 cycles of chemotherapy,the efficacy and quality of life of the two groups were compared,adverse reactions were observed,and progression survival(PFS) was followed.Result The response rate(RR) was 22.5% for the experimental group and 15.4% for the control group. There was no statistical difference(P=0.568).The disease control rate(DCR)was 67.5% and 41%, respectively.The difference was statistically significant(P=0.024).The median PFS for the experimental and control groups was 3.8 months(95% CI: 3.18-4.41 months) and 2.6 months(95% CI: 2.3-2.9 months),respectively,with a statistically significant difference(P=0.048).The main adverse reactions in the control group were granulocytopenia and fatigue,and the incidence of III-IV granulocytopenia and fatigue was 28.2% and23.1%, respectively,which was statistically different from the experimental group(P=0.048 and P=0.025).After chemotherapy,both groups improved in terms of physical function,role function, pain,and overall quality of life.In the experimental group,the social function and emotional function scores increased after chemotherapy,nausea,vomiting,and loss of appetite aggravated.The control group suffered from fatigue and dyspnea after chemotherapy.Compared with the data of two groups after chemotherapy,the fatigue symptoms in the control group was more obvious than the experimental group,and the overall quality of life of experimental group was higher than the control group,and the differences were statistically significant.Conclusion The efficacy of S-1 combined with lobaplatin in the secondlinetreatment of advanced lung squamous cell carcinoma is better than that of docetaxel combined with lobaplatin, the quality of life is improved, and the adverse reactions are tolerable.
引文
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[7]王村.替吉奥联合奈达铂对比多西他赛联合顺铂二线治疗晚期肺鳞癌患者的临床效果评估[J].临床医药文献电子杂志,2018,5(13):172.
[2] Lazzari C,Karachaliou N,Gregorc V,et al.Second-line therapy of squamous non-small cell lung cancer:an evolving landscape[J].Expert review of respiratory medicine,2017,11(6):469-479.
[3]朱以香,邢镨元,李峻岭.晚期肺鳞癌的治疗[J].中国肺癌杂志,2016,19(10):687-691.
[4] Suzuki S,Karayama M,Inui N,et al.Continuation maintenance therapy with S-1 in chemotherapy-naive patients with advanced squamous cell lung cancer[J].Investigational new drugs,2016,34(4):490-496.
[5]商迪,尹胜杰,季洪波,等.替吉奥联合奈达铂对比多西他赛单药二线治疗晚期肺鳞癌的疗效观察[J].临床肿瘤学杂志,2016,21(11):1011-1014.
[6] Nokihara H,Lu S,Mok T S K et al.Randomized controlled trial of S-1 versus docetaxel in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy(East Asia S-1 Trial in Lung Cancer)[J].Ann.Oncol.2017,28(11):2698-2706.
[7]王村.替吉奥联合奈达铂对比多西他赛联合顺铂二线治疗晚期肺鳞癌患者的临床效果评估[J].临床医药文献电子杂志,2018,5(13):172.