Analysis Of The Efficacy And Prognostic Factors Of Second Line Treatment Of Small Cell Lung Cancer

Objective:Retrospective analysis of clinical data of patients with small cell lung cancer after drug resistance or recurrence and metastasis and receiving the second line Iriticoside regimen and etoposide regimen chemotherapy,To compare the efficacy and safety of the treatment group and etoposide group.Methods:Statistical analysis Clinical data of 70 patients with small cell lung cancer who underwent first-line treatment between January 2011 and October 2017 in the first affiliated Hospital of Nanchang University received a second-line Iritetecan combined platinum regimen after drug resistance or relapse and metastasis,And etoposide combined with platinum regimen chemotherapy.Survival status of each group was statistically analyzed by SPSS 22.0 software.The survival curve of each group was plotted using the K-M method.At the same time,single factor analysis and log-rank significance test were carried out on the factors which could affect survival,and the independent factors influencing survival prognosis were analyzed by Cox proportional model.result:1.In this study,70 patients were enrolled in the study,25 patients received second-line chemotherapy with EP regimen,and 45 patients received second-line chemotherapy with IP regimen.In the EP group,ORR was 20%,DCR was 56%,median OS and PFS were 6.6 months and 3.8 months,respectively;IIn the IP group,ORR was 15.6%,DCR was 57.8%,median OS and PFS were 6.5 months and 5.2months;There was no significant difference in ORR and DCR between the two groups(P were 0.887>0.05,0.885>0.05);There was no significant difference in median OS and PFS between the two groups(P were 0.917>0.05,0.116>0.05,respectively).In the EP group,grade III or IV anemia,thrombocytopenia,leukopeniawere observed in 20%,24%,and 24%,respectively;in the IP group,grade III or IV anemia,thrombocytopenia,and leukopenia were 15.6%,17.8%,and 20,respectively.%;There was no statistical difference between the two groups.In the EP group,there were 2 cases of malignant vomiting at grade III or IV,2 cases of delayed diarrhea in the IP group,and 3 cases of malignant vomiting at grade III or IV.2.A total of 47 patients had a relapse type,of which 18 patients received second-line chemotherapy with EP regimen and 29 patients received second-line chemotherapy with IP regimen.Among them,the ORR in group EP was 27.8%,DCR was 61.1%,the median OS and PFS were 7.9 months and May respectively,the ORR in IP group was 13.3%,DCR was 60%,the median OS and PFS were 7.1 months and5.2 months,respectively.The ORR of the EP group was superior to the IP group,but it was not statistically significant(P=0.709>0.05).There was no significant difference in DCR between the two groups(P=0.939>0.05).There was no statistical difference in median OS and PFS between the two groups(P were 0.65>0.05 and 0.206>0.05).3.A total of 23 patients were refractory to relapse,of which 7 patients received second-line chemotherapy with EP regimen and 16 patients received second-line chemotherapy with IP regimen.In the EP group,there were no patients with PR or CR,ORR was 0%,DCR was 42.9%,median OS and PFS were 3.5 months and 2.1months,respectively;IP group had ORR of 18.8%,DCR was 50%,median OS and PFS were For 6.1 months and 3.6 months.There was no significant difference in ORR and DCR between the two groups(P > 0.05).The OS and PFS of IP group were better than that of EP group.The median OS and PFS of the two groups were significantly different(P were 0.003 <0.05,0.023 <0.05).4.By univariate analysis,the statistically significant prognostic factors affecting the overall survival of patients with second-line SCLC were age,recurrence type,tumor stage,liver metastasis,and ECOG score.The statistically significant factors affecting progression-free survival were age,recurrence type,liver metastasis,and ECOG score.5.By multivariate analysis,the independent prognostic factors affecting the overall survival of patients with second-line SCLC were: recurrence type,liver metastasis,and number of chemotherapy cycles;the independent prognostic factorsaffecting the progression-free survival of patients with second-line SCLC were: age,recurrence type,ECOG score,tumor stage.Conclusion:1.The curative effects of irinotecan combined with platinum and etoposide combined with podocaine second-line treatment were all reliable and the toxic and side effects were tolerable.There was no significant difference between the two groups.2.The combination of irinotecan with platinum and etoposide combined with polocylates in sensitive SCLC is effective and comparable.However,in refractory SCLC,irinotecan plus platinum is superior to etoposide combined with moors.3.Recurrence type,liver metastasis and the number of chemotherapy cycles can be considered as independent prognostic factors of second line therapy of SCLC,while age,recurrence type and tumor stage are independent prognostic factors of second line treatment of PFS in SCLC patients.