伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响

陈维领; 李鑫; 陈杼君; 刘攀; 唐春兰; 宫亮

doi:10.16016/j.1000-5404.201910211

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伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响

临床医学 | 更新时间：2026-01-09

- 伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响
- Effect of irinotecan combined with platinum first-line chemotherapy on brain metastasis of small cell lung cancer
- 第三军医大学学报 2020年42卷第5期页码：487-492
- 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：
  
  [宫亮，E-mail:gongl16@qq.comGONG Liang, E-mail: gongl16@qq.com
- 基金信息：
  
  国家自然科学基金面上项目(81772463)
- DOI：10.16016/j.1000-5404.201910211
  中图分类号： R73-37;R734.2;R979.1
- 收稿：2019-10-30，
  
  修回：2019-12-11，
  
  纸质出版：2020-03-15
- 稿件说明：
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陈维领, 李鑫, 陈杼君, 等. 伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响[J]. 第三军医大学学报, 2020,42(5):487-492.

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.
陈维领, 李鑫, 陈杼君, 等. 伊立替康联合铂类一线化疗对小细胞肺癌脑转移的影响[J]. 第三军医大学学报, 2020,42(5):487-492. DOI： 10.16016/j.1000-5404.201910211.

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

BRAY F, FERLAY J, SOERJOMATARAM I, et al . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J ] . CA Cancer J Clin, 2018, 68(6): 394-424. DOI:10.3322/caac.21492.

LU T, YANG X D, HUANG Y W, et al . Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades[J ] . Cancer Manag Res, 2019, 11: 943- 953. DOI:10.2147/CMAR.S187317.

LUKAS R V, GONDI V, KAMSON D O, et al . State-of-the-art considerations in small cell lung cancer brain metastases[J ] . Oncotarget, 2017, 8(41): 71223-71233. DOI:10.18632/oncotarget.19333.

SCHILD S E, SIO T T, DANIELS T B, et al . Prophylactic cranial irradiation for extensive small-cell lung cancer[J ] . J Oncol Pract, 2017, 13(11): 732-738. DOI:10.1200/JOP.2017.026765.

MOHAMMAD A S, GRIFFITH J I, ADKINS C E, et al . Liposomal irinotecan accumulates in metastatic lesions, crosses the blood-tumor barrier (BTB), and prolongs survival in an experimental model of brain metastases of triple negative breast cancer[J ] . Pharm Res, 2018, 35(2): 31. DOI:10.1007/s11095-017-2278-0.

SEVINC A, KALENDER M E, ALTINBAS M, et al . Irinotecan as a second-line monotherapy for small cell lung cancer[J ] . Asian Pac J Cancer Prev, 2011, 12(4): 1055-1059. DOI:10.1097/01.cad.0000390767.85658.83.

ABDEL KARIM N, BHATT A, CHIEC L, et al . Systemic chemotherapy for progression of brain metastases in extensive-stage small cell lung cancer[J ] . Case Rep Oncol Med, 2015, 2015: 620582. DOI:10.1155/2015/620582.

NODA K, NISHIWAKI Y, KAWAHARA M, et al . Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer[J ] . N Engl J Med, 2002, 346(2): 85-91. DOI:10.1056/NEJMoa003034.

HANNA N, BUNN P A Jr, LANGER C, et al . Randomized phase Ⅲ trial comparing irinotecan/cisplatin with etoposide/cisplatin in patients with previously untreated extensive-stage disease small-cell lung cancer[J ] . J Clin Oncol, 2006, 24(13): 2038-2043. DOI:10.1200/JCO.2005.04.8595.

LARA P N Jr, NATALE R, CROWLEY J, et al . Phase Ⅲ trial of irinotecan/cisplatin compared with etoposide/cisplatin in extensive-stage small-cell lung cancer: clinical and pharmacogenomic results from SWOG S0124[J ] . J Clin Oncol, 2009, 27(15): 2530-2535. DOI:10.1200/JCO.2008.20.1061.

SCHMITTEL A, SEBASTIAN M, FISCHER VON WEIKERSTHAL L, et al . A German multicenter, randomized phase Ⅲ trial comparing irinotecan-carboplatin with etoposide-carboplatin as first-line therapy for extensive-disease small-cell lung cancer[J ] . Ann Oncol, 2011, 22(8): 1798-1804. DOI:10.1093/annonc/mdq652.

SCHMITTEL A, FISCHER VON WEIKERSTHAL L, SEBASTIAN M, et al . A randomized phase Ⅱ trial of irinotecan plus carboplatin versus etoposide plus carboplatin treatment in patients with extended disease small-cell lung cancer[J ] . Ann Oncol, 2006, 17(4): 663-667. DOI:10.1093/annonc/mdj137.

KIM D W, KIM H G, KIM J H, et al . Randomized phase Ⅲ trial of irinotecan plus cisplatin versus etoposide plus cisplatin in chemotherapy-naïve Korean patients with extensive-disease small cell lung cancer[J ] . Cancer Res Treat, 2019, 51(1): 119-127. DOI:10.4143/crt.2018.019.

陈玉洁, 陈凌霄, 钟殿胜, 等.一线化疗方案治疗广泛期小细胞肺癌的网状meta分析[J].中国肺癌杂志, 2016, 19(4): 184-191. DOI:10.3779/j.issn.1009-3419.2016.04.02.

CHEN Y J, CHEN L X, ZHONG D S, et al . First-line chemotherapy for extensive-disease small cell lung cancer: A network meta-analysis[J ] . Chin J Lung Cancer, 2016, 19(4): 184-191. DOI:10.3779/j.issn.1009-3419.2016.04.02.

KUO Y C, CHANG Y H, RAJESH R.Targeted delivery of etoposide, carmustine and doxorubicin to human glioblastoma cells using methoxy poly(ethylene glycol)-poly(ε caprolactone) nanoparticles conjugated with wheat germ agglutinin and folic acid[J]. Mater Sci Eng C Mater Biol Appl, 2019, 96: 114-128. DOI:10.1016/j.msec.2018.10.094.

SUN Y W, XU J, ZHOU J, et al . Targeted drugs for systemic therapy of lung cancer with brain metastases[J ] . Oncotarget, 2018, 9(4): 5459-5472. DOI:10.18632/oncotarget.23616.

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