摘要
目的评估广泛期小细胞肺癌一线化疗联合免疫检查点抑制剂治疗有效后序贯胸部放疗的安全性和疗效。方法回顾性分析江苏省肿瘤医院2019年1月至2022年9月期间收治的广泛期小细胞肺癌患者资料。经一线化疗联合免疫治疗有效的患者,序贯行胸部放疗,采用常见不良事件评价标准(CTCAE)5.0评估安全性,Kaplan-Meier法分析其总生存(OS)期、无进展生存(PFS)期。结果纳入患者33例,中位年龄为66(50~79)岁。中位随访时间为20(3~33)个月,15例(46%)患者出现疾病进展,12例(36%)死亡。不良反应主要是白细胞减少、血小板减少、放射性食管炎、食欲下降、乏力等,6例(18%)患者出现4级血液学不良反应,主要是白细胞减少。1例(3%)发生3级放射性肺炎,3例(9%)发生1-2级放射性肺炎。全组患者中均未出现5级不良反应。中位PFS期为12个月(95%CI为3.9~20.1),6个月、1年和2年PFS率分别为78%、49.6%和35.6%。中位OS期为23个月(95%CI,15.98~30.01),6个月、1年和2年的OS率分别为86.2%、74.5%和47.2%。结论广泛期小细胞肺癌一线化疗联合免疫治疗后序贯胸部放疗安全性良好,并通过提高中位PFS率及OS率给患者带来生存获益。
Objective To evaluate the safety and efficacy of sequential consolidation thoracic radiotherapy after first-line chemotherapy combined with immunotherapy for extensive-stage small cell lung cancer(SCLC).Methods A retrospective analysis of patients with extensive-stage SCLC admitted to Jiangsu Cancer Hospital from January 2019 to September 2022 was conducted.Patients who achieved effective chemotherapy combined with immunotherapy received sequential consolidation thoracic radiotherapy.The safety was evaluated according to the common terminology criteria for adverse events(CTCAE)5.0 standard,and the overall survival(OS)and progression-free survival(PFS)were analyzed by Kaplan-Meier method.Results A total of 33 patients were enrolled,with a median age of 66 years(range,50-79 years).The median follow-up time was 20 months(range,3-33 months).Fifteen patients(46%)had disease progression,and 12 patients(36%)died.The toxicities mainly included leukopenia,thrombocytopenia,radiation esophagitis,anorexia,and fatigue,etc.Six patients(18%)had grade 4 hematological toxicity,mainly leukopenia.One patient(3%)had grade 3 radiation pneumonitis,and 3 patients(9%)had grade 1-2 radiation pneumonitis.No grade 5 toxicity was observed in all patient groups.The median PFS was 12 months(95%CI=3.9-20.1).The 6-month,1-year,and 2-year PFS rates were 78%,49.6%,and 35.6%,respectively.The median OS was 23 months(95%CI=15.98-30.01).The 6-month,1-year,and 2-year OS rates were 86.2%,74.5%,and 47.2%,respectively.Conclusions Sequential consolidation thoracic radiotherapy after first-line chemotherapy combined with immunotherapy is a safe protocol for extensive-stage SCLC.It brings survival benefits to patients by increasing PFS and OS rates.
作者
孟凡伟
宗丹
丁乃昕
许琦涔
夏国豪
何侠
朱向帜
Meng Fanwei;Zong Dan;Ding Naixin;Xu Qicen;Xia Guohao;He Xia;Zhu Xiangzhi(Department of Radiation Oncology,Suzhou First People's Hospital,Suzhou 234000,China;Department of Radiation Oncology,The Affiliated Cancer Hospital of Nanjing Medical University,Jiangsu Cancer Hospital,Jiangsu Institute of Cancer Research,Nanjing 210009,China;The Fourth Clinical Medical College of Nanjing Medical University,Nanjing 210009,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2024年第2期110-115,共6页
Chinese Journal of Radiation Oncology
基金
江苏省肿瘤医院临床科技攀登计划-“求真”临床研究专项(ZL202105)。
关键词
小细胞肺癌
广泛期
化学疗法
放射疗法
免疫疗法
Small cell lung carcinoma,extensive stage
Chemotherapy
Radiotherapy
Immunotherapy
作者简介
通信作者:朱向帜,Email:13182948068@163.com。
