Fujiwara Yutaka, Sekine Ikuo, Tsuta Koji, Ohe Yuichiro, Kunitoh Hideo, Yamamoto Noboru, Nokihara Hiroshi, Yamada Kazuhiko, Tamura Tomohide
Divisions of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.
Jpn J Clin Oncol. 2007 Jul;37(7):482-6. doi: 10.1093/jjco/hym053. Epub 2007 Jul 24.
The efficacy of chemotherapy in patients with large cell neuroendocrine carcinoma of the lung (LCNEC) remains unclear.
Of 42 consecutive patients with LCNEC, 22 with measurable disease receiving chemotherapy were enrolled as the subjects of this study. The clinical characteristics and objective responses to chemotherapy in these patients were analysed retrospectively.
The distribution of the disease stage in the patients consisting of 21 males and one female (median age: 67 years; range: 47-78 years) was as follows: stage IIB (n = 1), stage IIIA (n = 1), stage IIIB (n = 5), stage IV (n = 8), and post-operative recurrence (n = 7). Chemotherapy consisted of cisplatin and irinotecan (n = 9), a platinum agent and paclitaxel (n = 6), paclitaxel alone (n = 1), cisplatin and vinorelbine (n = 1), cisplatin and docetaxel (n = 1), and a platinum and etoposide (n = 4). The objective response rate in the 22 patients was 59.1% (95% CI, 38.1-80.1). An objective response was obtained in five of the nine patients receiving irinotecan and five of the seven patients receiving paclitaxel. The progression-free survival, median overall survival and 1-year survival rates were 4.1 months (95% CI, 3.1-5.1), 10.3 months (95% CI, 5.8-14.8) and 43.0% (95% CI, 20.7-65.3), respectively. The median overall survival of the patients treated with irinotecan or paclitaxel was 10.3 months (95% CI, 0-21.8), and the 1-year survival rate of these patients was 47.6% (95% CI, 20.4-74.8).
Our results suggest that irinotecan and paclitaxel may be active against LCNEC.
肺大细胞神经内分泌癌(LCNEC)患者化疗的疗效仍不明确。
连续纳入42例LCNEC患者,其中22例有可测量病灶且接受化疗的患者作为本研究对象。对这些患者的临床特征及化疗的客观反应进行回顾性分析。
21例男性和1例女性患者(中位年龄:67岁;范围:47 - 78岁)的疾病分期分布如下:IIB期(n = 1)、IIIA期(n = 1)、IIIB期(n = 5)、IV期(n = 8)及术后复发(n = 7)。化疗方案包括顺铂和伊立替康(n = 9)、铂类药物和紫杉醇(n = 6)、单纯紫杉醇(n = 1)、顺铂和长春瑞滨(n = 1)、顺铂和多西他赛(n = 1)以及铂类和依托泊苷(n = 4)。22例患者的客观缓解率为59.1%(95%CI,38.1 - 80.1)。接受伊立替康治疗的9例患者中有5例获得客观缓解,接受紫杉醇治疗的7例患者中有5例获得客观缓解。无进展生存期、中位总生存期和1年生存率分别为4.1个月(95%CI,3.1 - 5.1)、10.3个月(95%CI,5.8 - 14.8)和43.0%(95%CI,20.7 - 65.3)。接受伊立替康或紫杉醇治疗患者的中位总生存期为10.3个月(95%CI,0 - 21.8),这些患者的1年生存率为47.6%(95%CI,20.4 - 74.8)。
我们的结果表明伊立替康和紫杉醇可能对LCNEC有效。