Yin Yi, Wu Biao, Huang Zhangzhou, Zhuang Wu, Xu Zhenwu, Huang Cheng, Huang Yunjian, Zhang Jing
Department of Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China.
Zhongguo Fei Ai Za Zhi. 2018 Jun 20;21(6):437-444. doi: 10.3779/j.issn.1009-3419.2018.06.03.
There is no standard treatment for advanced non-small cell lung cancer (NSCLC) after the failure of two lines of chemotherapy, S-1 as the third generation of fluorouracil derivate with well safety and low toxicity, presented some efficacy in lung cancer treatment. The aim of this study is to explore the efficacy of S-1 for advanced NSCLC patients treated with two or more prior chemotherapy regimens.
We performed a retrospective analysis of 105 NSCLC patients treated with S-1 monotherapy or S-1 contained chemotherapy as the third or more line of treatment in our hospital from January 2014 to April 2017. S-1 was administrated orally twice daily for 2 weeks, followed by one week of rest, the dose of drug was determined by body surface area (<1.25 m2, 80 mg/d; 1.25 m2-1.5 m2, 100 mg/d; ≥1.5 m2, 120 mg/d), platinum or the third-generation chemotherapy drugs could be combinedly used. Clinical response was assigned every cycle according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Kaplan-Meier analysis was used to estimate progression-free survival (PFS).
42 patients received S-1 monotherapy, the other 63 patients received combined regimens, the median treatment line was 4 (3-11) and the median treatment cycle was 2 (1-14). No complete response (CR) were observed, there were 4 patients with partial response (PR), 34 patients with stable disease (SD) and 67 patients with progressive disease (PD), the objective response rate (ORR) was 3.81%, disease control rate (DCR) was 36.19%. The median PFS was 1.90 months (0.67 months-10.83 months), no difference between monotherapy and combined group (DCR: 28.56% vs 41.27%, P=0.185), the liver metastasis showed poorer PFS (1.40 months vs 1.93 months , P=0.042).
S-1 presented some activity in advanced NSCLC treated with more than two lines of treatment. The addition of other drugs cannot improve efficacy. S-1 monotherapy can be used as a choice for heavily-treated patients.
对于经过两线化疗失败后的晚期非小细胞肺癌(NSCLC),尚无标准治疗方案。S-1作为第三代氟尿嘧啶衍生物,安全性好、毒性低,在肺癌治疗中显示出一定疗效。本研究旨在探讨S-1对接受过两种或更多线既往化疗方案治疗的晚期NSCLC患者的疗效。
我们对2014年1月至2017年4月在我院接受S-1单药治疗或含S-1化疗作为第三线或更多线治疗的105例NSCLC患者进行了回顾性分析。S-1口服给药,每日两次,共2周,随后休息1周,药物剂量根据体表面积确定(<1.25 m2,80 mg/d;1.25 m2 - 1.5 m2,100 mg/d;≥1.5 m2,120 mg/d),可联合使用铂类或第三代化疗药物。根据实体瘤疗效评价标准(RECIST)1.1版在每个周期评估临床反应,采用Kaplan-Meier分析评估无进展生存期(PFS)。
42例患者接受S-1单药治疗,另外63例患者接受联合方案治疗,中位治疗线数为4(3 - 11),中位治疗周期为2(1 - 14)。未观察到完全缓解(CR),有4例部分缓解(PR)患者,34例疾病稳定(SD)患者和67例疾病进展(PD)患者,客观缓解率(ORR)为3.81%,疾病控制率(DCR)为36.19%。中位PFS为1.90个月(0.67个月 - 10.83个月),单药治疗组与联合组之间无差异(DCR:28.56% vs 41.27%,P = 0.185),肝转移患者的PFS较差(1.40个月 vs 1.93个月,P = 0.042)。
S-1在接受两线以上治疗的晚期NSCLC中显示出一定活性。添加其他药物并不能提高疗效。S-1单药治疗可作为重度治疗患者的一种选择。