Background: Standard care for patients with inoperable advanced non-small cell lung cancer (NSCLC) is concurrent chemoradiotherapy. The ideal concurrent chemotherapy regimen has not been determined. The aim of this study is to retrospectively analyze the efficacy and safety of concurrent radiotherapy with carboplatin/paclitaxel administrated every three weeks (PC three-week regimen) in inoperable advanced NSCLC and compare them with the results of cisplatin/etoposide.
Methods: The 43 patients with inoperable advanced NSCLC receiving concurrent chemotherapy in Peking Union Medical College Hospital from January 2012 to June 2014 were enrolled and analyzed. Of them, 15 patients received carboplatin/paclitaxel with concurrent thoracic radiotherapy; the other 28 patients received cisplatin/etoposide. Clinical characteristic, efficacy and toxicity data were compared in these two groups.
Results: For the overall population, the objective response rate (ORR) and disease control rate (DCR) were 41.9% and 90.7% respectively. The median progression free survival (PFS) was 10.6 months (95%CI: 7.4-13.8). And the median overall survival (OS) was 19.2 months (95%CI: 15.3-23.1). There were no significant differences in response rates (ORR: 33.3% vs 46.4%; DCR: 86.7% vs 92.9%, P=0.638), PFS (6.6 months vs 12.2 months, P=0.389), or OS (16.1 months vs 22.1 months, P=0.555) in either group. The adverse events were generally manageable and no treatment-related deaths occurred.
Conclusions: Compared with PE, PC three-week regimen concurrent thoracic radiotherapy for inoperable advanced NSCLC has the similar efficacy and acceptable toxicity profile, which can be used in clinical setting.
背景与目的 对于局部晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）同步放化疗是推荐的标准治疗。理想的化疗方案并未确立。本研究拟回顾性分析紫杉醇/卡铂（paclitaxel/carboplatin, PC）三周方案同步胸部放疗治疗局部晚期NSCLC的疗效和安全性，并与标准的依托泊苷/顺铂（cisplatin/etoposide, PE）方案进行比较。方法 回顾性分析北京协和医院2012年1月-2014年6月收治的局部晚期NSCLC患者共43例，其中15例接受PC三周方案同步胸部放疗，28例接受PE方案同步胸部放疗。比较两组患者的临床特征、疗效和不良反应。结果 全组患者：客观缓解率（objective response rate, ORR）为41.9%，疾病控制率（disease control rate, DCR）为90.7%，中位无疾病进展生存时间（progression-free survival, PFS）为10.6个月（95%CI: 7.4-13.8），中位总生存期（overall survival, OS）为19.2个月（95%CI: 15.3-23.1）。PC组和PE组在疗效上无统计学差异（ORR：33.3% vs 46.4%，DCR：86.7% vs 92.9%，P=0.638；PFS：6.6个月 vs 12.2个月，P=0.389；OS：16.1个月 vs 22.1个月，P=0.555）。不良反应可处理，两组均未发生治疗相关死亡。结论 PC三周方案同步胸部放疗治疗局部晚期NSCLC与标准PE方案疗效相似，不良反应可接受，在临床中可采用。.