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两例复发性非小细胞肺癌经S-1作为五线化疗成功治疗

[Two cases of recurrent non-small cell lung cancer successfully treated with S-1 as fifth-line chemotherapy].

作者信息

Takakuwa Osamu, Oguri Tetsuya, Sato Shigeki, Nakao Makoto, Ohta Chiharu, Iwashima Yasuhito, Miyazaki Mikinori, Maeno Ken, Kutsuna Takeo, Nakamura Atsushi, Ueda Ryuzo

机构信息

Dept. of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences.

出版信息

Gan To Kagaku Ryoho. 2009 Oct;36(10):1721-4.

Abstract

There is at present no defined role for S-1 chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who previously failed chemotherapy. Two cases of multidrug-resistant, NSCLC that were successfully treated with S-1 as fifth-line chemotherapy are reported. A 75-year-old man was diagnosed as having pulmonary adenocarcinoma, cT1N3M0, stage III B. He was treated with S-1 as fifth-line chemotherapy after treatment with cisplatin(CDDP)and vinorelbine(VNR), docetaxel (DOC), gemcitabine (GEM) and VNR, and amrubicin (AMR). After completing two courses, chest computed tomography(CT)showed a partial response( PR)of the recurrent tumors, and the serum carcinoembryonic antigen level decreased. Currently, seven courses have been completed, and this treatment will be continued due to the tumor response of stable disease. A 65-year-old woman was referred for treatment of recurrent pulmonary adenocarcinoma after right upper lobe resection. She was treated with S-1 as fifth-line chemotherapy after treatment with GEM and VNR, carboplatin(CBDCA) and paclitaxel ( PTX), DOC, and gefitinib. After completing five courses, chest CT showed PR of the intrapulmonary metastases. Though grade 3 toxicity-anemia in the first case and an elevated serum amylase level in the second case were observed in both cases, the patients' quality of life was preserved. S-1 could therefore be a treatment option for patients with advanced NSCLC who previously underwent chemotherapy unsuccessfully.

摘要

对于既往化疗失败的晚期非小细胞肺癌(NSCLC)患者,目前S-1化疗尚无明确作用。本文报告了2例多药耐药的NSCLC患者,接受S-1作为五线化疗获得成功治疗。1例75岁男性被诊断为肺腺癌,cT1N3M0,ⅢB期。在接受顺铂(CDDP)和长春瑞滨(VNR)、多西他赛(DOC)、吉西他滨(GEM)和VNR以及氨柔比星(AMR)治疗后,接受S-1作为五线化疗。完成两个疗程后,胸部计算机断层扫描(CT)显示复发性肿瘤部分缓解(PR),血清癌胚抗原水平下降。目前已完成七个疗程,由于肿瘤反应为疾病稳定,将继续该治疗。1例65岁女性在右上叶切除术后因复发性肺腺癌前来治疗。在接受GEM和VNR、卡铂(CBDCA)和紫杉醇(PTX)、DOC以及吉非替尼治疗后,接受S-1作为五线化疗。完成五个疗程后,胸部CT显示肺内转移灶部分缓解。尽管两例患者均观察到3级毒性反应,第一例为贫血,第二例为血清淀粉酶水平升高,但患者的生活质量得以维持。因此,对于既往化疗失败的晚期NSCLC患者,S-1可能是一种治疗选择。

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