Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer

Weiling CHEN; Xin LI; Zhujun CHEN; Pan LIU; Chunlan TANG; Liang GONG

doi:10.16016/j.1000-5404.201910211

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Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer

Clinical Medicine | 更新时间：2026-01-09

- Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer
- Journal of Third Military Medical University Vol. 42, Issue 5, Pages: 487-492(2020)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院呼吸与危重症医学科
- 作者简介：
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(81772463)
- DOI：10.16016/j.1000-5404.201910211
  CLC： R73-37;R734.2;R979.1
- Received：30 October 2019，
  
  Revised：2019-12-11，
  
  Published：15 March 2020
- 稿件说明：
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Weiling CHEN, Xin LI, Zhujun CHEN, et al. Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer[J]. Journal of Third Military Medical University, 2020, 42(5): 487-492.
DOI：

Weiling CHEN, Xin LI, Zhujun CHEN, et al. Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer[J]. Journal of Third Military Medical University, 2020, 42(5): 487-492. DOI： 10.16016/j.1000-5404.201910211.

摘要

目的

探讨伊立替康联合铂类对比依托泊苷联合铂类一线化疗对小细胞肺癌(small cell lung cancer，SCLC)患者脑转移的影响。

方法

回顾性分析2011年11月至2018年7月本院收治的126例基线无脑转移的SCLC患者，其中一线接受伊立替康方案化疗的84例(IP组)，一线接受依托泊苷方案化疗的42例(EP组)，比较两组一线治疗后的客观缓解率(ORR)、疾病控制率(DCR)、中位无进展生存期(PFS)，以及中枢神经系统肿瘤(CNS)进展和非CNS进展的累积发生率。

结果

IP组和EP组的ORR分别为79.8%、76.2%，差异无统计学意义(

=0.645)，DCR分别为89.3%、92.9%，差异无统计学意义(

=0.748)。IP组的中位PFS为7.500±0.779(5.974~9.026)个月，EP组的中位PFS为5.500±0.648(4.230~6.770)个月，两者差异有统计学意义(

=0.015)。与EP组比较，IP组局限期和广泛期小细胞肺癌患者的脑转移风险比分别为0.270，95%

:0.096~0.760(

=0.013)；0.914，95%

:0.281~2.973(

=0.881)。治疗3个月后，IP组的局限期患者脑转移累积发病率均低于EP组，其1年的脑转移累计发生率分别为14.3%、31.8%。

结论

伊立替康联合铂类一线化疗局限期小细胞肺癌患者的脑转移时间较依托泊苷联合铂类一线化疗晚。

Abstract

Objective

To investigate the effects of platinum-based first-line chemotherapy combined with irinotecan versus with etoposide on brain metastasis of small cell lung cancer patients (SCLC).

Methods

A retrospective analysis was carried out in 126 SCLC patients without brain metastases admitted to our hospital from November 2011 to July 2018

including 84 patients receiving irinotecan chemotherapy in the first line (IP group)

and 42 patients undergoing etoposide treatment in the first line (EP group)

both based on platinum treatment. Objective response rate (ORR)

disease control rate (DCR)

and median progression-free survival (PFS)

and cumulative incidence of central nervous system (CNS) and non-CNS progression after first-line treatment were compared between the 2 groups.

Results

For the IP group and the EP group

the ORR were 79.8% and 76.2%

respectively (

=0.645)

and the DCR was 89.3% and 92.9%

respectively (

=0.748). The median PFS was 7.500±0.779 (5.974~9.026) months in the IP group

and 5.500±0.648 (4.230~6.770) months in the EP group

and statistical difference was seen between them (

=0.015). Compared with the EP group

the risk ratios of brain metastasis in IP patients with limited and extensive stages of SCLC were 0.270 (95%

: 0.096~0.760

=0.013) and 0.914 (95%

: 0.281~2.973

=0.881). In 3 months after treatment

the cumulative incidence of brain metastases in patients with limited stage was lower in the IP group than the EP group

and the incidence at 1 year was 14.3% and 31.8%

respectively.

Conclusion

IP chemotherapy delays the brain metastasis of SCLC patients when compared with EP treatment.

关键词

Keywords

references

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