晚期非小细胞肺癌NP方案化疗相关性白细胞减少与化疗疗效关系

Chemotherapy-induced Leucopenia and Treatment Outcomes of NP Regimen in Patients with Advanced Non-small Cell Lung Cancer

  • 摘要: 目的: 评价NP方案化疗的晚期NSCLC患者CIL与化疗疗效之间的关系。 方法: 对128例Ⅰ~Ⅳ期NSCLC患者采用NP化疗方案:顺铂35mg/m2,静脉滴注,第1,2天;长春瑞滨25mg/m2,静脉滴注,第1,8天,每21天为1周期。根据CIL程度进行分组:无CIL的患者为A组;轻度CIL(GⅠ~Ⅱ)为B组;重度CIL(GⅢ~Ⅳ)为C组。主要研究目的为有效率(RR)、疾病控制率(DCR)和疾病进展时间(TTP)。 结果: 共有128例患者入组。A、B、C三组RR率分别为30.8%,56.8%和71.4%,P=0.010,出现CIL的患者RR率明显增高。DCR率分别为61.5%,83.8%和92.9%,P=0.009,CIL患者DCR率也明显提高。中位TTP分别为150天(95%CI:91~209),189天(95%CI:181~197)和207天(95%CI:172~242),P=0.009,CIL患者TTP明显延长。CIL持续至少10天的患者TTP延长明显,P=0.0213。轻度CIL伴ECOG0的患者TTP也明显延长,P=0.0412。 结论: CIL与NP方案化疗的晚期NSCLC患者的RR和TTP有关,随CIL的出现患者RR率提高,TTP延长,尤其是轻度CIL伴ECOG0和CIL持续10天以上的患者。因此,CIL可以作为反映药物活性和预测化疗疗效的指标。

     

    Abstract: Objective: To evaluate the chemotherapy-induced leucopenia (CIL) and treatment outcomes of NP regimen in pa-tients with advanced non-small cell lung cancer(NSCLC). Methods: The chemotherapy consisted of Cisplatin 35mg/m2 (Ⅳ,on the first two days) and Vinorelbine 25mg/m2 (Ⅳ, on the first and eighth day). Each cycle consisted of 21 days. The pa-tients were classified into three groups: Group A consisted of the patients who had grade 0 leucopenia, group B consisted of the patients who had grade Ⅰ~Ⅱ leucopenia, and group C consisted of the patients who had grade Ⅲ~Ⅳ leucopenia.Indices including response rate(RR), disease control rate(DCR), and time to progression(TTP) were analyzed. Results: Atotal of 128 patients were enrolled. The RR in group A, B and C was 30.8%, 56.8% and 71.4%, respectively (P=0.010).The DCR in group A, B and C was 61.5%, 83.8% and 92.9%, respectively (P=0.009). The median TTP in group A, B and C was 150 days(95% CI: 91-209), 189 days(95% CI: 181-197) and 207 days(95% CI: 172-242), respectively(P=0.009).In those patients who had CIL for at least 10 days, the TTP was longer(P=0.0213). Patients with grade I~II leucopenia and ECOG 0 had longer TTP (P=0.0412). Conclusion: The occurrence of CIL is correlated with RR and TTP in patients with advanced NSCLC treated with Cisplatin and Vinorelbine. CIL can be a biological measure of drug activity and an index for efficacy.

     

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