Lehoczky Ottó, Pulay Tamás
Országos Onkológiai Intézet Nogyógyászati Osztály, Budapest.
Orv Hetil. 2007 Dec 9;148(49):2337-42. doi: 10.1556/OH.2007.28132.
Second-line chemotherapies result in a progression-free interval of 2,3-42 months.
The authors evaluated the efficacy of second-line paclitaxel-carboplatin, topotecan, and cisplatin-epirubicin-etoposide combinations.
Paclitaxel-carboplatin (175 mg/m2 and AUC 5) in 3-week intervals and topotecan (1.5 mg/m2/d1-3) in 3-week intervals was given to 13 and 16 patients. The triple combination of cisplatin-epirubicin-etoposide was applied in 48 patients in 4-week courses, with doses of 33 mg/m2/d1-3, 60 mg/m2/d1, and 100 mg/m2/d1-3., respectively. The progression-free interval was calculated by the product limit method of Kaplan-Meier.
A significantly better progression-free interval was observed in treatments with paclitaxel-carboplatin and cisplatin-epirubicin-etoposide compared to the topotecan chemotherapy (5 and 5.5 months vs. 4 months, respectively, p = 0.0324 and p = 0.0087). A better progression-free interval was found in the platinum-sensitive tumors compared to the platinum-resistant ones by the above mentioned combinations (6 and 3.5 months, 7 and 4 months, and 6.5 and 3.5 months, respectively).
The lower priced cisplatin-epirubicin-etoposide combination resulted in a slightly better efficacy compared to the 2 other treatments both in platinum-sensitive and platinum-resistant tumors.
二线化疗可带来2至42个月的无进展生存期。
作者评估了二线紫杉醇-卡铂、拓扑替康和顺铂-表柔比星-依托泊苷联合方案的疗效。
分别对13例和16例患者每3周给予一次紫杉醇-卡铂（175mg/m²和AUC 5）以及每3周给予一次拓扑替康（1.5mg/m²/d1 - 3）。顺铂-表柔比星-依托泊苷三联方案应用于48例患者，每4周为一个疗程，剂量分别为33mg/m²/d1 - 3、60mg/m²/d1和100mg/m²/d1 - 3。无进展生存期采用Kaplan-Meier乘积限法计算。
与拓扑替康化疗相比，紫杉醇-卡铂和顺铂-表柔比星-依托泊苷治疗的无进展生存期显著更长（分别为5个月和5.5个月对比4个月，p = 0.0324和p = 0.0087）。上述联合方案在铂敏感肿瘤中的无进展生存期优于铂耐药肿瘤（分别为6个月和3.5个月、7个月和4个月、6.5个月和3.5个月）。
价格较低的顺铂-表柔比星-依托泊苷联合方案在铂敏感和铂耐药肿瘤中，疗效均略优于其他两种治疗方案。
