Yashiki Chiho, Hirose Takashi, Sugiyama Tomohide, Kusumoto Sojiro, Shirai Takao, Ohmori Tohru, Adachi Mitsuru, Nakamura Akihiro
Dept. of Pharmaceutics, Showa University School of Medicine.
Gan To Kagaku Ryoho. 2010 Feb;37(2):245-9.
We examined the association between chemotherapy-induced myelosuppression and prognosis in limited-stage disease small cell lung cancer (LD SCLC). We retrospectively analyzed 76 patients with LD SCLC who received combination cisplatin or carboplatin of etoposide or irinotecan. Patients were categorized into two groups (grade 0 to 2 or grade 3 to 4) according to the worst neutropenia, anemia, or thrombocytopenia during first-line chemotherapy and were analyzed for overall survival (OS) and time to progression (TTP). From univariate analysis, OS was significantly better in patients who developed grade 0 to 2 anemia or thrombocytopenia than those who developed grade 3 to 4. In addition, performance status, neuron-specific enolase (NSE), and pro-gastrin-releasing protein were identified as prognostic factors. By multi-variate analysis, NSE was an independent prognostic factor for OS. There were no independent prognostic factors for TTP. Myelosuppression during chemotherapy is not a prognostic factor in LD SCLC. Our results show doses of platinum doublet chemotherapy were adequate in patients with LD SCLC.
我们研究了化疗引起的骨髓抑制与局限期小细胞肺癌(LD SCLC)预后之间的关联。我们回顾性分析了76例接受顺铂或卡铂联合依托泊苷或伊立替康治疗的LD SCLC患者。根据一线化疗期间最严重的中性粒细胞减少、贫血或血小板减少情况,将患者分为两组(0至2级或3至4级),并分析总生存期(OS)和疾病进展时间(TTP)。单因素分析显示,发生0至2级贫血或血小板减少的患者的OS明显优于发生3至4级的患者。此外,体能状态、神经元特异性烯醇化酶(NSE)和胃泌素释放肽前体被确定为预后因素。多因素分析显示,NSE是OS的独立预后因素。TTP没有独立的预后因素。化疗期间的骨髓抑制不是LD SCLC的预后因素。我们的结果表明,铂类双联化疗剂量对LD SCLC患者是足够的。