S-1（替吉奥，即替加氟、吉美嘧啶和奥替拉西钾）与三维适形放疗同步用于老年初诊肺鳞状细胞癌患者的疗效和安全性

Efficacy and safety of S-1 (tegafur, gimeracil, and oteracil potassium) concurrent with 3-dimensional conformal radiotherapy for newly diagnosed squamous cell carcinoma of the lung in elderly patients.

作者信息

Wang T, Zhang S-F, Qiu M-Q, Li Q-L

机构信息

Department of Medical Oncology, Zaozhuang Municipal Hospital, 277102 Zaozhuang, China.

出版信息

Cancer Radiother. 2016 May;20(3):181-6. doi: 10.1016/j.canrad.2015.12.004. Epub 2016 Apr 7.

DOI:10.1016/j.canrad.2015.12.004

PMID:27068497

Abstract

PURPOSE

This study evaluated the efficacy and safety of the combination drug tegafur, gimeracil, and oteracil potassium (S-1) concurrent with 3-dimensional conformal radiotherapy for newly diagnosed squamous cell carcinoma of the lung in elderly patients.

PATIENTS AND METHODS

Patients with pathologically or cytologically newly diagnosed lung squamous cell carcinoma (n=106) were randomly assigned to receive the combination of tegafur, gimeracil, and oteracil potassium (40mg/m(2), BID, d1-28, repeated every 6 weeks for 4 cycles) and concurrent 3D-conformal radiotherapy (60Gy; experimental group), or gemcitabine (800-1000mg/m(2), d1 and d8) repeated every 21 days for 4 cycles as well as 3D-conformal radiotherapy (control group).

RESULTS

The overall response rate (complete and partial responses) of the experimental group was 68.6%, which was significantly higher than that of the control group (38.5%; P=0.002). The median progression-free survival rates of the experimental and control groups were 11.8 months (95% confidence interval [CI]: 8.0-22.4) and 7.8 months (95% CI, 6.9-9.2), respectively (P=0.017). Adverse reactions included grade I/II radiation esophagitis and pneumonitis, with good tolerance. Grade III/IV adverse reactions of the experimental and control groups were leucopenia (20% cf. 56.6%, respectively; P=0.027), thrombocytopenia (3.9% cf. 25%; P=0.037), and gastrointestinal reaction (1.9% cf. 3.5%; P=0.35).

CONCLUSION

The efficacy of concurrent combination chemotherapy with tegafur, gimeracil, and oteracil potassium (S-1) and 3D-conformal radiotherapy for newly diagnosed squamous cell carcinoma of the lung in elderly patients was excellent, and all toxicities were well tolerated. This treatment might be considered a main regimen in the management of squamous cell carcinoma of the lung in elderly patients.

摘要

目的

本研究评估替吉奥（替加氟、吉美嘧啶和奥替拉西钾）联合三维适形放疗对老年初诊肺鳞状细胞癌患者的疗效和安全性。

患者与方法

将病理或细胞学确诊的初诊肺鳞状细胞癌患者（n = 106）随机分为两组，试验组接受替吉奥（40mg/m²，每日2次，第1 - 28天，每6周重复1次，共4个周期）联合三维适形放疗（60Gy）；对照组接受吉西他滨（800 - 1000mg/m²，第1天和第8天），每21天重复1次，共4个周期以及三维适形放疗。

结果

试验组的总缓解率（完全缓解和部分缓解）为68.6%，显著高于对照组（38.5%；P = 0.002）。试验组和对照组的中位无进展生存期分别为11.8个月（95%置信区间[CI]：8.0 - 22.4）和7.8个月（95% CI，6.9 - 9.2）（P = 0.017）。不良反应包括Ⅰ/Ⅱ级放射性食管炎和肺炎，耐受性良好。试验组和对照组的Ⅲ/Ⅳ级不良反应分别为白细胞减少（20% 对比 56.6%；P = 0.027）、血小板减少（3.9% 对比 25%；P = 0.037）和胃肠道反应（1.9% 对比 3.5%；P = 0.35）。