Sekine Ikuo, Sumi Minako, Satouchi Miyako, Tsujino Kayoko, Nishio Makoto, Kozuka Takuyo, Niho Seiji, Nihei Keiji, Yamamoto Nobuyuki, Harada Hideyuki, Ishikura Satoshi, Tamura Tomohide
Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Division of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Cancer Sci. 2016 Mar;107(3):315-9. doi: 10.1111/cas.12875. Epub 2016 Feb 19.
To evaluate the feasibility of amrubicin plus cisplatin (AP) following chemoradiotherapy for limited-disease small-cell lung cancer, chemo-naïve patients aged 20-70 years with a performance status of 0 or 1 and normal organ functions were treated with etoposide 100 mg/m2 on days 1-3, cisplatin 80 mg/m(2) on day 1 and concurrent thoracic radiotherapy at 45 Gy/30 fractions (EP-TRT), followed by three cycles of amrubicin 40 mg/m2 on days 1-3 and cisplatin 60 mg/m2 on day 1 every 3 weeks. The EP-TRT could be completed in 21 patients (15 male and 6 female patients with a median age of 62 years). Of these, 2, 1 and 18 (86%) patients received one, two and three cycles of AP, respectively. Sixteen (76%) patients required granulocyte-colony stimulating factor (G-CSF) support. Grade 3/4 neutropenia occurred in all patients. Grade 3 febrile neutropenia was observed in 9 patients, lasting for 1 day in 5 patients. The incidences of grade 3/4 thrombocytopenia and anemia were 43 and 24%, respectively. Grade 3 infection and anorexia occurred in 2 and 3 patients, respectively. The response rate was 95%. The median (95% confidence interval [CI]) progression-free survival (PFS) was 41.9 (0-102) months, and the 5-year PFS rate (CI) was 41.9% (20.4-63.4%). The median overall survival (OS) has not been reached yet, and the 5-year OS rate (CI) was 57.8% (35.2-80.4%). In conclusion, EP-TRT followed by AP therapy was well-tolerated, although a large number of patients required G-CSF support.
为评估氨柔比星联合顺铂（AP）方案用于局限期小细胞肺癌放化疗后的可行性，对年龄20 - 70岁、体能状态为0或1且器官功能正常的初治患者，于第1 - 3天给予依托泊苷100 mg/m²，第1天给予顺铂80 mg/m²，并同时进行45 Gy/30次分割的胸部放疗（EP-TRT），随后每3周进行3个周期的治疗，第1 - 3天给予氨柔比星40 mg/m²，第1天给予顺铂60 mg/m²。21例患者（15例男性和6例女性，中位年龄62岁）完成了EP-TRT。其中，分别有2例、1例和18例（86%）患者接受了1个、2个和3个周期的AP治疗。16例（76%）患者需要粒细胞集落刺激因子（G-CSF）支持。所有患者均发生3/4级中性粒细胞减少。9例患者出现3级发热性中性粒细胞减少，其中5例持续1天。3/4级血小板减少和贫血的发生率分别为43%和24%。分别有2例和3例患者发生3级感染和厌食。缓解率为95%。中位（95%置信区间[CI]）无进展生存期（PFS）为41.9（0 - 102）个月，5年PFS率（CI）为41.9%（20.4 - 63.4%）。中位总生存期（OS）尚未达到，5年OS率（CI）为57.8%（35.2 - 80.4%）。总之，EP-TRT序贯AP治疗耐受性良好，尽管大量患者需要G-CSF支持。
