术后辅助化疗后复发转移与初次诊断的IV期NSCLC一线化疗疗效分析

doi:10.11904/j.issn.1002-3070.2018.02.003

实用肿瘤学杂志 ›› 2018, Vol. 32 ›› Issue (2): 107-111.doi: 10.11904/j.issn.1002-3070.2018.02.003

术后辅助化疗后复发转移与初次诊断的IV期NSCLC一线化疗疗效分析

翟可可¹, 高媛媛², 冯晓¹, 许静文¹, 宫玉芳¹, 孟庆威¹

1.哈尔滨医科大学附属肿瘤医院肿瘤内科(哈尔滨 150081);
2.宁夏医科大学总医院肿瘤医院肿瘤内科

收稿日期:2018-01-09 出版日期:2018-04-28 发布日期:2018-05-09
通讯作者: 孟庆威,E-mail:mqwei@ems.hrbmu.edu.cn
作者简介:翟可可,女,(1990-),硕士研究生,从事恶性肿瘤转移早期筛查及肺癌综合治疗的研究。
基金资助:
国家自然科学基金面上项目(编号:81672931);国家博士后基金项目(编号:2016M591552);黑龙江省博士后基金项目(编号:LBH-Z16254)

Analysis of first-line NSCLC chemotherapy in the phase Ⅳ patients with distant metastasis and first diagnosis after postoperative adjuvant chemotherapy

ZHAI Keke¹, GAO Yuanyuan², FENG Xiao¹, XU Jingwen¹, GONG Yufang¹, MENG Qingwei¹

1.Department of Medical Oncology,Harbin Medical University Cancer Hospital,Harbin 150081,China;
2.Department of Medical Oncology,General Hospital of Ningxia Medical University Tumor Hospital

Received:2018-01-09 Online:2018-04-28 Published:2018-05-09

摘要/Abstract

摘要： 目的既往行根治性手术治疗的非小细胞肺癌(NSCLC)患者,即使进行了系统的术后辅助化疗,仍有很多不可避免的复发,甚至远处转移。同时,很多患者在初治时即为Ⅳ期。本文旨在探讨术后辅助化疗后远处转移的NSCLC患者一线化疗(First-line chemotherapy at recurrence post-adjuvant chemotherapy,FCRPC)与初治Ⅳ期NSCLC患者一线化疗(Initial first-line chemotherapy,IFC)的疗效对比。方法研究对象为603例远处转移非小细胞肺癌患者,其中73例为FCRPC组,530例为IFC组。采用倾向性评分匹配的统计学方法平衡两组间的临床特征,卡方检验进行两组间近期疗效对比。并采用Cox回归分析法和Kaplan-Meier分析法进行生存分析。结果在远处转移NSCLC患者中,FCRPC组的客观有效率(ORR)及疾病控制率(DCR)与IFC组无统计学差异(ORR率:FCRPC组27.4% vs. IFC组24.7%,P=0.851;DCR率:FCRPC组78.1% vs. IFC组65.6%,P=0.140)。FCRPC组与IFC组的中位无进展生存期(中位PFS:9.8个月 vs. 8.5个月,P=0.337)与中位总生存期(中位OS:20.0个月 vs. 14.4个月,P=0.087)均无统计学差异。结论术后辅助化疗后远处转移NSCLC与初治Ⅳ期NSCLC患者一线化疗的预后无统计学差异。

关键词: 非小细胞肺癌, 远处转移, 一线化疗, 生存分析, 疗效评价

Abstract: Objective In patients with non-small cell lung cancer(NSCLC)undergoing radical surgery,there were still many inevitable recurrences and distant metastases,even after systemic postoperative adjuvant chemotherapy.At the same time,many patients were in the stage Ⅳ at the time of initial treatment.The aims of this study were to investigate and compare the first-line chemotherapy(First-line Chemotherapy at Recurrence Post-adjuvant Chemotherapy,FCRPC)in NSCLC patients with distant metastasis after adjuvant chemotherapy with initial treatment at the phase Ⅳ of NSCLC patients with first-line chemotherapy(Initial First-line Chemotherapy,IFC).Methods A total of 603 patients with distant metastatic NSCLC were collected in this study.Among them,73 of them were FCRPC and 530 of them for IFC.Statistical methods for propensity score matching were used to balance the clinical features between FCRPC and IFC groups.Chi-square test was used to compare the short-term efficacy between FCRPC and IFC groups.Survival analysis was performed using regression analysis and Kaplan-Meier analysis.Results There was no significant difference in Objective response rate(ORR)and disease control rate(DCR)between FCRPC and IFC groups in NSCLC patients with distant metastases(ORR rate:27.46% in the FCRPC group,24.7% in the PFC group,P=0.851 and DCR rate:78.1% in the FCRPC group,65.6% in the PFC group,P=0.140).There was also no significant difference in the median progression-free survival(9.8 months in the FCRPC group and 8.5 months in the PFC group,P=0.337)and median overall survival(20.0 months in the FCRPC group and 14.4 months in the PFC group,P=0.087).Conclusion There is no significant difference in the prognosis of first-line chemotherapy between NSCLC patients with distant metastases and with initial treatment at the stage Ⅳ after adjuvant chemotherapy.

Key words: Non-small cell lung cancer, Distant metastasis, First-line chemotherapy, Survival analysis, Efficacy evaluation

中图分类号:

R734.2

翟可可, 高媛媛, 冯晓, 许静文, 宫玉芳, 孟庆威. 术后辅助化疗后复发转移与初次诊断的IV期NSCLC一线化疗疗效分析[J]. 实用肿瘤学杂志, 2018, 32(2): 107-111.

ZHAI Keke, GAO Yuanyuan, FENG Xiao, XU Jingwen, GONG Yufang, MENG Qingwei. Analysis of first-line NSCLC chemotherapy in the phase Ⅳ patients with distant metastasis and first diagnosis after postoperative adjuvant chemotherapy[J]. PRACTICAL ONCOLOGY JOURNAL, 2018, 32(2): 107-111.

参考文献

1 Valdes M,Nicholas G,Goss GD,et al.Chemotherapy in recurrent advanced non-small-cell lung cancer after adjuvant chemotherapy[J].Curr Oncol,2016,23(6):386-390.
2 Besse B,Adjei A,Baas P,et al.2nd ESMO Consensus Conference on Lung Cancer:non-small-cell lung cancer first-line/second and further lines of treatment in advanced disease[J].Ann Oncol,2014,25(8):1475-1484.
3 Saisho S,Yasuda K,Maeda A,et al.Post-recurrence survival of patients with non-small-cell lung cancer after curative resection with or without induction/adjuvant chemotherapy[J].Interact Cardiovasc Thorac Surg,2013,16(2):166-172.
4 Douillard JY,Rosell R,De Lena M,et al.Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer(Adjuvant Navelbine International Trialist Association[ANITA]):a randomised controlled trial[J].Lancet Oncol,2006,7(9):719-727.
5 Eisenhauer EA,Therasse P,Bogaerts J,et al.New response evaluation criteria in solid tumors:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45:228-247.
6 Dehejia R,Wahba S.Propensity score matching methods for non experimental causal studies[J].Rev Econ Statistics,2002,84:151-161.
7 姚晓军,刘伦旭.肺癌的流行病学及治疗现状[J].现代肿瘤医学,2014,22(8):1982-1986.
8 Sculier JP,Meert AP.Third-generation chemotherapy agents in the treatment of advanced non-small cell lung cancer:a meta-analysis[J].J Thorac Oncol,2008,3(3):320-322.
9 Sekine I,Nokihara H,Yamamoto N,et al,Comparative chemotherapeutic efficacy in non-small cell lung cancer patients with postoperative recurrence and stage IV disease[J].J Thorac Oncol,2009,4(4):518-521.
10 Hoang T,Xu R,Schiller JH,et al.Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data[J].J Clin Oncol,2005,23(1):175-183.

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术后辅助化疗后复发转移与初次诊断的IV期NSCLC一线化疗疗效分析

Analysis of first-line NSCLC chemotherapy in the phase Ⅳ patients with distant metastasis and first diagnosis after postoperative adjuvant chemotherapy

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