Xu Sheng, Li Yuan-Ming, Bie Zhi-Xin, Li Xiao-Guang
Department of Minimally Invasive Tumor Therapies Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Quant Imaging Med Surg. 2023 Jan 1;13(1):339-351. doi: 10.21037/qims-22-530. Epub 2022 Nov 3.
Patients with small cell lung cancer (SCLC) are prone to developing refractoriness to standard treatment, and some patients are ineligible for systemic therapy owing to comorbidities or poor pulmonary function. The prognosis of patient with standard treatment-refractory/ineligible (STRI)-SCLC remains poor. This retrospective cohort study aimed to investigate the efficacy and safety of drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) for the treatment of SRTI-SCLC and to identify the predictors of overall survival (OS).
A total of 18 patients with STRI-SCLC who received DEB-BACE were included. Treatment response, adverse events, progression-free survival (PFS), and OS were evaluated. Further molecular targeted therapy or immunotherapy was administered as a second-line treatment or beyond for those patients who had not received these regimens previously. Univariate and multivariate Cox analyses were used to explore the predictors of OS for STRI-SCLC treated with DEB-BACE.
The overall disease control rate at 3 months after DEB-BACE was 77.8% (14/18); of these patients who experienced disease control, partial response and stable disease were achieved in 2 patients (11.1%) and 12 patients (66.7%), respectively. There were 7 patients (38.9%) who received anlotinib after DEB-BACE. No severe DEB-BACE-related or anlotinib-related adverse events were observed. The median PFS was 5.0 months; the 6- and 12-month PFS rates were 55.6% (10/18) and 11.1% (2/18), respectively. The median OS was 9.0 months; the 6- and 12-month OS rates were 77.8% (14/18) and 33.3% (6/18), respectively. Postoperative anlotinib [hazard ratio: 0.302; 95% confidence interval (CI): 0.098-0.930; P=0.037] was identified as the predictor of OS in patients with STRI-SCLC treated with DEB-BACE.
DEB-BACE is an effective and well-tolerated approach for patients with STRI-SCLC. Postoperative anlotinib is the predictor of OS and may indicate a better prognosis for patients with STRI-SCLC.
小细胞肺癌（SCLC）患者易于对标准治疗产生耐药性，并且一些患者由于合并症或肺功能差而不符合全身治疗的条件。标准治疗难治性/不符合条件（STRI）-SCLC患者的预后仍然很差。这项回顾性队列研究旨在调查药物洗脱微球支气管动脉化疗栓塞术（DEB-BACE）治疗STRI-SCLC的疗效和安全性，并确定总生存期（OS）的预测因素。
共纳入18例接受DEB-BACE治疗的STRI-SCLC患者。评估治疗反应、不良事件、无进展生存期（PFS）和OS。对于那些先前未接受过这些方案的患者，给予进一步的分子靶向治疗或免疫治疗作为二线治疗或后续治疗。采用单因素和多因素Cox分析来探索接受DEB-BACE治疗的STRI-SCLC患者OS的预测因素。
DEB-BACE术后3个月的总体疾病控制率为77.8%（14/18）；在这些疾病得到控制的患者中，分别有2例（11.1%）达到部分缓解，12例（66.7%）病情稳定。有7例（38.9%）患者在DEB-BACE术后接受了安罗替尼治疗。未观察到严重的与DEB-BACE相关或与安罗替尼相关的不良事件。中位PFS为5.0个月；6个月和12个月的PFS率分别为55.6%（10/18）和11.1%（2/18）。中位OS为9.0个月；6个月和12个月的OS率分别为77.8%（14/18）和33.3%（6/18）。术后使用安罗替尼[风险比：0.302；95%置信区间（CI）：0.098 - 0.930；P = 0.037]被确定为接受DEB-BACE治疗的STRI-SCLC患者OS的预测因素。
DEB-BACE是治疗STRI-SCLC患者的一种有效且耐受性良好的方法。术后使用安罗替尼是OS的预测因素，可能表明STRI-SCLC患者有更好的预后。
