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[目的]探讨含铂双药化疗和单药化疗用于难治复发小细胞肺癌(small cell lung cancer,SCLC)患者二线化疗的疗效及安全性。[方法 ]回顾性分析101例难治性SCLC患者二线治疗的疗效和生存情况,并采用Cox多因素分析模型进行预后相关因素的分析。[结果]单药和双药组有效率(response rate,RR)分别为2.9%和7.5%(P=0.208),疾病控制率(disease control rate,DCR)分别为14.7%和59.7%(P<0.001),中位无进展生存期(progression-free survival,PFS)分别为1.23个月和2.77个月(P<0.001)。两组中位总生存期(overall survival,OS)差异无统计学意义(5.40个月vs 5.93个月,P=0.988)。Ⅲ~Ⅳ度不良反应单药组比双药组发生率低(20.6%vs 52.2%,P=0.007)。多因素分析显示体能状况评分(performance status,PS)(HR=1.491,P=0.002)是PFS的独立影响因素。[结论 ]双药治疗可延长部分患者的PFS,但不良反应相对增加。
[Objective] To investigate the efficacy and safety of platinum-based chemotherapy and monotherapy in second-line chemotherapy in patients with refractory and relapsed small cell lung cancer (SCLC). [Methods] The efficacy and survival of second-line treatment of 101 patients with refractory SCLC were retrospectively analyzed. Cox regression model was used to analyze the prognostic factors. [Results] The response rates (RR) were 2.9% and 7.5% (P = 0.208) and the disease control rates (DCR) were 14.7% and 59.7% in single drug group and double drug group respectively (P < 0.001). The median progression-free survival (PFS) was 1.23 months and 2.77 months (P <0.001), respectively. There was no significant difference in overall survival (OS) between the two groups (5.40 vs 5.93 months, P = 0.988). Grade III-IV adverse reactions were lower in the single drug group than in the double drug group (20.6% vs 52.2%, P = 0.007). Multivariate analysis showed that the performance status (PS) (HR = 1.491, P = 0.002) was an independent factor of PFS. [Conclusion] The double-drug treatment can prolong the PFS of some patients, but the adverse reaction is relatively increased.