Chen Li-Kun, Liang Ying, Yang Qun-Ying, Xu Fei, Zhou Ning-Ning, Xu Guang-Chuan, Liu Guo-Zhen, Wei Wei-Dong
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, State Key Laboratory of Oncology in South China, Guangzhou, China.
Asian Pac J Cancer Prev. 2012;13(5):1863-7. doi: 10.7314/apjcp.2012.13.5.1863.
Maintenance chemotherapy is one strategy pursued in recent years with intent to break through the chemotherapy plateau for advanced non-small cell lung cancer (NSCLC). However, given the toxicity, platinum-based combinations are rarely given for this purpose. We carried out the present prospective study of triplet platinum-based combination sequential chemotherapy in advanced NSCLC to investigate if patients could tolerate and benefit from such intensive treatment.
From Dec 2003 to Dec 2007, 190 stage IIIB and IV NSCLC patients in Sun yat-sen University sequentially received the 3 platinum-based combination (TP- NP-GP) treatment (T: paclitaxol 175 mg/m2 d1; N: vinorelbine 25 mg/m2 d1 and 8; G: gemcitabine 1 g/m2 d1 and 8; P: cisplatin 20 mg/m2 d1-5; repeated every 3 weeks). Patients were followed up to at least 3 years to obtain survival data. Treatment toxicities and the quality of life (QOL) were assessed during the whole treatment.
There were 187 patients evaluable. The TP, NP and GP response rates with sequential use were 42.8% (80/187), 41.1% (65/158) and 28.8% (21/73) respectively. Median survival time was 18.2 months and the 1, 2 and 3 year overall survival (OS) rates were 78.7%, 38.5% and 21.3%. Patients receiving>6 cycles of chemotherapy had significantly longer OS and TTP (MST 25.3 vs. 14.5 months, TTP 15.1 vs. 9.1 months). The QOL on the whole for the patients was improved after chemotherapy.
The sequential chemotherapy strategy with triplet platinum-based combination regimens can improve the survival outcome and the quality of life of advanced non-small cell lung cancer patients.
维持化疗是近年来为突破晚期非小细胞肺癌（NSCLC）化疗平台期而采用的一种策略。然而，鉴于毒性，基于铂类的联合方案很少用于此目的。我们开展了本次关于晚期NSCLC三联铂类联合序贯化疗的前瞻性研究，以调查患者是否能够耐受并从这种强化治疗中获益。
2003年12月至2007年12月，中山大学的190例IIIB期和IV期NSCLC患者序贯接受三联铂类联合（TP-NP-GP）治疗（T：紫杉醇175mg/m² d1；N：长春瑞滨25mg/m² d1和8；G：吉西他滨1g/m² d1和8；P：顺铂20mg/m² d1-5；每3周重复一次）。对患者进行至少3年的随访以获取生存数据。在整个治疗过程中评估治疗毒性和生活质量（QOL）。
有187例患者可评估。序贯使用时TP、NP和GP的缓解率分别为42.8%（80/187）、41.1%（65/158）和28.8%（21/73）。中位生存时间为18.2个月，1年、2年和3年总生存（OS）率分别为78.7%、38.5%和21.3%。接受>6周期化疗的患者OS和TTP显著更长（MST 25.3对14.5个月，TTP 15.1对9.1个月）。化疗后患者总体QOL得到改善。
三联铂类联合方案的序贯化疗策略可改善晚期非小细胞肺癌患者的生存结局和生活质量。
