Lu Hongyang, Qin Jing, Han Na, Xie Fajun, Gong Lei, Li Chenghui
1 Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
Integr Cancer Ther. 2018 Dec;17(4):1109-1114. doi: 10.1177/1534735418801532. Epub 2018 Sep 19.
Irinotecan (CPT-11) can be used as a first-line therapeutic drug against extensive-stage small cell lung cancer (SCLC); it can also be used in second-line treatment for SCLC. CPT-11-induced delayed diarrhea restricts its clinical application. This study aimed to confirm whether Banxia Xiexin decoction was effective in preventing and controlling CPT-11-induced delayed diarrhea.
A total of 27 patients with recurrent SCLC undergoing chemotherapy regimens including CPT-11 were enrolled for the study. UGT1A128, UGTlAl6, ABCB12, and SLCO1B115 gene polymorphisms were detected. If delayed diarrhea occurred in the first cycle of chemotherapy, Banxia Xiexin decoction was orally administered for 5 consecutive days starting 1 day before the second cycle of chemotherapy to prevent and control the delayed diarrhea. The objective response, overall survival, and toxicity were recorded.
Complete response, partial response, and stable disease were observed in none, 6, and 10 patients, respectively. Delayed diarrhea occurred in 6 patients, and 4 of 5 patients were relieved or controlled using Banxia Xiexin decoction. The median overall survival was 6 months.
Banxia Xiexin decoction appeared to prevent and control delayed diarrhea induced by CPT-11 in this small observational study, and further study with a larger sample size, including potentially randomized trials, is suggested.
伊立替康(CPT - 11)可作为广泛期小细胞肺癌(SCLC)的一线治疗药物;也可用于SCLC的二线治疗。CPT - 11引起的迟发性腹泻限制了其临床应用。本研究旨在证实半夏泻心汤对预防和控制CPT - 11引起的迟发性腹泻是否有效。
共纳入27例接受含CPT - 11化疗方案的复发性SCLC患者进行研究。检测UGT1A128、UGTlAl6、ABCB12和SLCO1B115基因多态性。若化疗第一周期出现迟发性腹泻,则在化疗第二周期前1天开始口服半夏泻心汤连续5天,以预防和控制迟发性腹泻。记录客观缓解情况、总生存期和毒性反应。
分别有0例、6例和10例患者观察到完全缓解、部分缓解和病情稳定。6例患者出现迟发性腹泻,5例患者中有4例使用半夏泻心汤后缓解或得到控制。中位总生存期为6个月。
在这项小型观察性研究中,半夏泻心汤似乎能预防和控制CPT - 11引起的迟发性腹泻,建议进行更大样本量的进一步研究,包括可能的随机试验。