Background and objective: How to prolong progression free survival (PFS) and overall survival (OS) of patients with small cell lung cancer (SCLC) has been one of the hottest issues. We retrospectively reviewed our data to compare the survival of immediate with delayed topotecan after first-line therapy in SCLC.
Methods: In our retrospective study, 53 patients with SCLC were divided into two groups as follow: patients receiving topotecan-containing regimen as maintenance/consolidation (maintenance/consolidation chemotherapy group) and salvage chemotherapy (salvage chemotherapy group). The Log-rank test was used to assess the difference in OS between two groups. Cox regression model was used for the multivariable analysis of independent prognostic factors.
Results: Twenty-nine patients received topotecan as maintenance/consolidation treatment, whereas 24 patients salvage chemotherapy. The response rates were 51.7% and 41.7%, respectively. The median survival time were 20 months and 27 months respectively (P = 0.89). Multivariate Cox regression analyses identified sex and stage as independent prognostic factors.
Conclusion: Efficacy of first-line therapy was improved by topotecan maintenance/ consolidation treatment, which did not result in any significant survival benefits in SCLC.
背景与目的: 小细胞肺癌（small cell lung cancer, SCLC）作为治疗有效率和复发率都很高的疾病，如何减少其复发或延长缓解时间、改善总生存，一直是目前亟待解决的问题。本研究旨在探索拓扑替康（topotecan, TPT）用于SCLC维持/巩固治疗的临床获益。
方法: 回顾性分析53例SCLC患者的治疗结果，按治疗方法分为两组：一线化疗取得缓解或稳定后用TPT维持或巩固的维持/巩固组和TPT用于二线或二线以后的挽救治疗组。用Log-rank法对总生存差别进行单因素分析比较，并行多因素Cox回归分析。
结果: 维持/巩固组29例，挽救化疗组24例，客观有效率分别为51.7%和41.7%，中位生存时间分别为20个月和27个月（P=0.89）。Cox回归分析显示仅性别和分期是有统计学意义的预后因素。
结论: 将TPT提前用于一线取得缓解或稳定的SCLC维持/巩固治疗能提高有效率，但未见生存优势。