摘要
目的探讨初始化疗2个周期后,疗效评价为疾病稳定（stable disease,SD）的晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）患者,后续治疗是否需要更换化疗方案,并比较两者无进展生存期（progression free survival,PFS）差异。方法收集2012-01-01-2012-12-31华中科技大学同济医学院附属协和医院肿瘤中心初诊晚期NSCLC患者45例,全部患者初始2个周期化疗后评价为SD,根据后续治疗有无更换化疗方案分为原药组（20例）和换药组（25例）,χ^2检验行临床特征分析,Kaplan-Meier法和Log-rank检验行生存曲线分析,Cox比例风险模型行单因素及多因素分析。结果初始2个周期化疗后评价为SD的NSCLC患者,中位PFS在原药组和换药组分别为131和199d,χ^2=5.376,P=0.020;在肺腺癌患者中,这一优势更加明显,中位PFS分别为119和201d,χ^2=11.195,P=0.001。客观缓解率（objective response rate,ORR）在原药组和换药组分别为5%（1/20）和4%（1/25）,疾病控制率（disease control rate,DCR）则分别为55%（11/20）和76%（19/25）;Cox回归分析结果显示,评价后更换方案与否是PFS独立预后因素,P=0.023,OR=0.479,95%CI为0.254-0.904。结论对于初始2个周期后疗效评价为SD的肺癌患者,尤其是肺腺癌患者,更换化疗方案可延长PFS。
OBJECTIVE The subsequent treatment for stable disease patients after first two cycles of chemotherapy is controversial. We intended to compare survival difference between continue and switch treatment of these patients. METHODS Forty-Five advanced NSCLC patients were retrospectively collected from Jan. lst,2012 to Dec. 31th,2012 in this study and these patients were evaluated SD after two cycles of first-line chemotherapy. We divided them into continue group and switch group according to the subsequent treatment. Chi-square test was used to analyse the clinical characters, Kaplan-Meier method and Log-rank test were applied to survival analysis, Cox regression analysis was used for hazard model. RESULT The median PFS in continue group and switch group were 131 days and 199 days, 2 = 5. 376,P= 0. 020. For adenocarcinoma patients, this advantage was more obvious （ 119 days vs 201 days, Х^2 = 11. 195, P = 0. 001 ）. ORR and DCR in continue group and switch group were 5 %（ 1/20）, 4 % （ 1/25） and 55 % （ 11/20）, 76 % （ 19/25 ） respectively. The subsequent treatment switch or not （P=0. 023） was independently related to PFS,OR was 0. 479 （95GCI： 0. 254-0. 904）. CONCLUSION For SD patients after initial two cycles of chemotherapy, switch treatment could help extend PFS especially in adenocarcinoma patients.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第23期1907-1910,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
癌
非小细胞肺
病情稳定
化学治疗
无疾病进展生存
cancer, non-small cell lung
stable disease
chemotherapy
progression-free survival
