化疗早期重度粒细胞下降与小细胞肺癌预后相关性分析

doi:10.11904/j.issn.1002-3070.2018.01.004

摘要/Abstract

摘要： 目的探讨小细胞肺癌一线EP方案(依托泊苷+顺铂)化疗期间早期重度粒细胞下降与其化疗疗效及临床预后之间的相关性。方法回顾性分析82例一线行EP方案化疗的小细胞肺癌患者的临床资料,根据患者重度粒细胞下降发生的时间分为早发组(前两周期内出现Ⅲ~Ⅳ度粒细胞下降)和非早发组(未出现或三周期及以后出现Ⅲ~Ⅳ度粒细胞下降),观察指标主要为化疗客观有效率(ORR)、疾病控制率(DCR)、疾病进展时间(TTP)及总生存期(OS),单因素生存分析采用Kaplan-Meier法和Log-rank检验,多因素生存分析采用Cox风险比例模型。结果早发组和非早发组化疗客观有效率分别为81.8%和75.5%(P=0.499),疾病控制率分别为97.0%和95.9%(P=1.000),中位疾病进展时间分别为10.4个月和6.9个月(P=0.001),中位总生存期分别为22.4个月和16.0个月(P=0.023),多因素生存分析显示吸烟指数、化疗周期数、胸部放疗及早期重度粒细胞下降是小细胞肺癌独立的预后因素(P＜0.05)。结论化疗相关性的早期重度粒细胞下降与小细胞肺癌化疗疗效相关,是小细胞肺癌预后良好的独立预测因素。

关键词: 小细胞肺癌, 化疗, 粒细胞减少, 预后

Abstract: Objective The aims of this study were to investigate the correlation between the early stage of severe granulocytopenia and the curative effect on clinical prognosis of chemotherapy in the first-line EP regimen of small cell lung cancer(SCLC). Methods A retrospective study analysis of 82 cases of first-line EP chemotherapy in patients with SCLC was collected clinical data,according to the time of patients with severe neutropenia.Patients were divided into two groups i.e.early-onset group(the first two cycles appeared Ⅲ-Ⅳ neutrophil decline)and non-early-onset group(Ⅲ~Ⅳ neutropenia did not appear or three cycles and later).The main indicators for the observation were objective response rate(ORR),disease control rate(DCR),time to progression(TTP)and overall survival(OS).Kaplan-Meier method and Log-rank test were used to analyze univariate survival and Cox proportional hazards model to analyze multivariate survival. Results The effective rates of chemotherapy were 81.8% and 75.5%(P=0.499),and DCRs were 97.0% and 95.9% in early-onset and non-early-onset groups,respectively(P＞0.05).The median survival time was 10.4 months and 6.9 months in early-onset and non-early-onset groups,respectively(P=0.001).The median OSs were 22.4 months and 16.0 months in early-onset and non-early-onset groups,respectively(P=0.023).Multivariate survival analysis revealed that smoking index,number of chemotherapy cycles,chest radiotherapy and early-onset severe neutropenia were independent prognostic factors for SCLC(P＜0.05). Conclusion Chemotherapy-related loss of early severe neutropenia correlates with the efficacy of chemotherapy in SCLC and is an independent predictor of prognosis in SCLC.

Key words: Small cell lung cancer, Chemotherapy, Neutropenia, Prognosis

中图分类号:

R734.2

杨文娟, 余静, 黄朝, 张俊红, 谢丛华. 化疗早期重度粒细胞下降与小细胞肺癌预后相关性分析[J]. 实用肿瘤学杂志, 2018, 32(1): 19-24.

YANG Wenjuan, YU Jing, HUANG Zhao, ZHANG Junhong, XIE Conghua. Correlation between the decline of severe granulocyte in the early stage of chemotherapy and the prognosis of small cell lung cancer[J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(1): 19-24.

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