Kang Shiyang, Lai Chaopeng Ou Ruifeng Xue Weian Zeng Jingxiu Huang Yingjun Zhang Dongtai Chen Jielan
Department of Anaesthesiology, Sun Yat-sen University Cancer Center, Guangzhou, China.
J BUON. 2021 Mar-Apr;26(2):306-312.
To explore the efficacy and safety of etoposide + cisplatin (EP) and irinotecan + cisplatin (IP) sequential chemotherapy combined with radiotherapy in the treatment of extensive-stage small-cell lung cancer (SCLC).
A total of 108 patients with extensive-stage SCLC were divided into the EP+IP group (n=54, sequential IP chemotherapy), and the EP group (n=54, EP chemotherapy). The changes in the level of serum tumor markers and the number of circulating tumor cells (CTCs) in the peripheral blood were compared between the two groups of patients before and after treatment. The patients were followed up to record the survival status and tumor progression.
The overall effective rate for bone metastases in the EP+IP group was significantly higher than that in the EP group. The EP+IP group displayed significantly lower levels of serum VEGF, Ki-67 and peripheral blood CTCs than the EP group. In addition, the follow-up results manifested that the median overall survival (OS) in the EP+IP group and the EP group were 16.2 months and 12.7 months, respectively, and the median progression-free survival (PFS) was 8.4 months and 5.9 months, respectively. The 2-year OS was 13.0% and 7.4%, respectively. Furthermore, the log-rank test illustrated that the OS and PFS in the EP+IP group were significantly superior to those in the EP group.
EP and IP sequential chemotherapy combined with radiotherapy is more effective than EP chemotherapy combined with radiotherapy in the treatment of extensive-stage SCLC. The former can markedly reduce the levels of serum tumor markers and peripheral blood CTCs, increase the long-term survival of patients and reduce the occurrence of blood-related adverse reactions.
探讨依托泊苷+顺铂（EP）与伊立替康+顺铂（IP）序贯化疗联合放疗治疗广泛期小细胞肺癌（SCLC）的疗效及安全性。
将108例广泛期SCLC患者分为EP+IP组（n=54，序贯IP化疗）和EP组（n=54，EP化疗）。比较两组患者治疗前后外周血血清肿瘤标志物水平及循环肿瘤细胞（CTC）数量的变化。对患者进行随访，记录生存状况及肿瘤进展情况。
EP+IP组骨转移的总有效率显著高于EP组。EP+IP组血清VEGF、Ki-67水平及外周血CTC数量均显著低于EP组。此外，随访结果显示，EP+IP组和EP组的中位总生存期（OS）分别为16.2个月和12.7个月，中位无进展生存期（PFS）分别为8.4个月和5.9个月。2年OS率分别为13.0%和7.4%。此外，对数秩检验表明，EP+IP组的OS和PFS显著优于EP组。
EP与IP序贯化疗联合放疗治疗广泛期SCLC比EP化疗联合放疗更有效。前者可显著降低血清肿瘤标志物水平及外周血CTC数量，提高患者长期生存率，减少血液相关不良反应的发生。
