Analysis of efficacy and survival of patients receiving second-line treatment for sensitive recurrent small-cell lung cancer / 肿瘤

ABSTRACT

Objective: This study is aimed to retrospectively evaluate and compare the efficacy and safety among topotecan, platinum-based rechallenge and other single agent therapies as secondline chemotherapy in patients with sensitive recurrent SCLC (small-cell lung cancer). Methods: Eightythree patients with sensitive recurrent SCLC were recruited in this study and their clinical records and follow-up information were retrospectively reviewed. The efficacy of the second-line chemotherapy was evaluated, and the survival of these patients was analyzed. COX proportional hazards model analysis was conducted to find out the prognosis-related factors. Results: The median PFS (progression-free survival) in topotecan, platinum-based rechallenge and other single agent groups were 2.80, 4.07 and 1.93 months, respectively (P = 0.007); the median OS (overall survival) from the initiation of second-line chemotherapy in these three groups were 8.07, 10.57 and 7.27 months, respectively (P = 0.021); the rates of grades III-IV toxicities in these three groups were 47.6%, 69.2% and 30.0%, respectively (P = 0.033). The COX proportional hazards model analysis revealed that the factors of response to first-line chemotherapy (response vs stable disease/progression; hazard ratio = 1.27, P = 0.013), performance status score before second-line chemotherapy (0-1 vs 2; hazard ratio = 1.36, P = 0.019), and staging before secondline chemotherapy (limited vs extensive; hazard ratio = 2.16, P = 0.006) were independent prognostic predictors of OS after second-line chemotherapy. Conclusion: The sensitive recurrent SCLC patients who were classified as limited-stage SCLC and having a therapeutic response to first-line chemotherapy and a performance status score of 0-1 may benefit from the second-line chemotherapy. Platinum-based rechallenge as a second-line chemotherapy regimen has an advantage of prolonged PFS and OS as compared with topotecan or other single agent therapy. Copyright © 2012 by TUMOR.