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氨柔比星治疗难治性和复发性小细胞肺癌的疗效与安全性回顾性分析

Retrospective analysis of efficacy and safety of amrubicin in refractory and relapsed small-cell lung cancer.

作者信息

Shimokawa Tsuneo, Shibuya Masahiko, Kitamura Kazuhiro, Hosomi Yukio, Hibino Suguru, Ota Tomohiro, Iguchi Mari, Okamura Tatsuru, Gemma Akihiko

机构信息

Department of Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, Tokyo, Japan.

出版信息

Int J Clin Oncol. 2009 Feb;14(1):63-9. doi: 10.1007/s10147-008-0802-2. Epub 2009 Feb 20.

Abstract

BACKGROUND

Amrubicin, a totally synthetic 9-aminoanthracycline, was evaluated retrospectively for the treatment of refractory and relapsed small-cell lung cancer (SCLC).

METHODS

Retrospective analysis was performed in 32 patients. Amrubicin was infused over 5 min on days 1-3, with courses repeated at 3- or 4-week intervals. Amrubicin was given at a dose of 45 mg/m(2) per day, 40 mg/m(2) per day, 35 mg/m(2) per day, 30 mg/m(2) per day, or 25 mg/m(2) per day depending on medical conditions (patients' age and performance status [PS]), and the dose was modulated according to myelosuppression.

RESULTS

The median number of treatment cycles was 3 (range, 1-6). Seventeen patients (53.1%) had a partial response. Median progression-free survival time for all patients was 96 days, and median survival time was 166 days. Grade 3 or 4 hematologic toxicities comprised neutropenia (78.1%), anemia (65.6%), and thrombocytopenia (50.0%). Febrile neutropenia was observed in 8 patients (25.0%). Nonhematologic toxicities were mild. Treatment-related death was observed in 1 patient.

CONCLUSION

Treatment with amrubicin appeared effective in SCLC patients previously treated with chemotherapy, although it was not necessarily safe, because of myelosuppression. Further research is warranted to investigate amrubicin treatment for patients with SCLC.

摘要

背景

氨柔比星是一种完全合成的9-氨基蒽环类药物,我们对其治疗难治性和复发性小细胞肺癌(SCLC)进行了回顾性评估。

方法

对32例患者进行回顾性分析。氨柔比星在第1 - 3天经5分钟静脉输注,疗程每3或4周重复一次。根据患者的具体情况(年龄和体能状态[PS]),氨柔比星的给药剂量分别为每日45mg/m²、40mg/m²、35mg/m²、30mg/m²或25mg/m²,并根据骨髓抑制情况调整剂量。

结果

治疗周期的中位数为3(范围1 - 6)。17例患者(53.1%)出现部分缓解。所有患者的无进展生存期中位数为96天,总生存期中位数为166天。3或4级血液学毒性包括中性粒细胞减少(78.1%)、贫血(65.6%)和血小板减少(50.0%)。8例患者(25.0%)出现发热性中性粒细胞减少。非血液学毒性较轻。1例患者出现与治疗相关的死亡。

结论

氨柔比星治疗先前接受过化疗的SCLC患者似乎有效,尽管由于骨髓抑制其安全性不一定可靠。有必要进一步研究氨柔比星对SCLC患者的治疗作用。

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