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S-1联合顺铂同步放疗与单纯顺铂同步放疗治疗Ⅲ期非小细胞肺癌的一项探索性随机对照试验

S-1 plus cisplatin with concurrent radiotherapy versus cisplatin alone with concurrent radiotherapy for stage III non-small cell lung cancer: a pilot randomized controlled trial.

作者信息

Yao Lei, Xu Shidong, Xu Jianyu, Yang Chaoyang, Wang Junfeng, Sun Dawei

机构信息

Department of Chest Surgery, Third Affiliated Hospital of Harbin Medical University, Haping Road No.150, Nangang District, Harbin, Heilongjiang Province, 150081, China.

出版信息

Radiat Oncol. 2015 Jan 9;10:10. doi: 10.1186/s13014-014-0306-3.

Abstract

BACKGROUND

We investigated the efficacy and safety of S-1 and cisplatin with concurrent thoracic radiation (SCCR) over cisplatin alone plus concurrent thoracic radiation (CCR) for unresectable stage III non-small-cell lung cancer (NSCLC).

METHODS

Between January 2009 and November 2011, 40 eligible patients with NSCLC were included and divided randomly into two groups. Twenty patients received SCCR with S-1 (orally at 40 mg/m(2) per dose, b.i.d.) on days 1 through 14, cisplatin (60 mg/m(2) on day 1) every 4 weeks for two cycles, and radiotherapy (60 Gy/30 fractions over 6 weeks) beginning on day 1. Twenty subjects received CCR (cisplatin and radiotherapy, the same as for SCCR).

RESULTS

The 3-year overall response rate was 59.3% and 52.4% for the SCCR and CCR groups, respectively, and the difference was statistically significant, while the median overall survival was 33 months (range, 4-41 months) and 24 months (range, 2-37 months), respectively (P = 0.048). The median progression-free survival was 31 months for SCCR (range, 5-39 months), whereas it was 20 months (range, 2-37 months) for CCR (P = 0.037). The toxicity profile was similar in both groups.

CONCLUSION

In summary, we demonstrated that S-1 and cisplatin with concurrent thoracic radiation was more effective than cisplatin plus radiotherapy in NSCLC patients with acceptable toxicity.

TRIAL REGISTRATION

Chinese Clinical Trials Register: ChiCTR-TRC-13003997 .

摘要

背景

我们研究了S-1和顺铂同步胸部放疗(SCCR)对比单纯顺铂同步胸部放疗(CCR)用于不可切除的III期非小细胞肺癌(NSCLC)的疗效和安全性。

方法

2009年1月至2011年11月,纳入40例符合条件的NSCLC患者并随机分为两组。20例患者接受SCCR,S-1(每日40mg/m²,分两次口服,第1至14天),顺铂(第1天60mg/m²)每4周一次,共两个周期,放疗(6周内60Gy/30次分割)从第1天开始。20例患者接受CCR(顺铂和放疗,与SCCR相同)。

结果

SCCR组和CCR组的3年总缓解率分别为59.3%和52.4%,差异有统计学意义,而中位总生存期分别为33个月(范围4 - 41个月)和24个月(范围2 - 37个月)(P = 0.048)。SCCR组的中位无进展生存期为31个月(范围5 - 39个月),而CCR组为20个月(范围2 - 37个月)(P = 0.037)。两组的毒性特征相似。

结论

总之,我们证明了S-1和顺铂同步胸部放疗在NSCLC患者中比顺铂加放疗更有效且毒性可接受。

试验注册

中国临床试验注册中心:ChiCTR - TRC - 13003997 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abf/4311504/08a979e13a90/13014_2014_306_Fig1_HTML.jpg

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