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塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌的临床观察

周然, 王峰, 庞丽娜, 曹蕾, 樊青霞

周然, 王峰, 庞丽娜, 曹蕾, 樊青霞. 塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌的临床观察[J]. 肿瘤防治研究, 2014, 41(09): 1031-1035. DOI: 10.3971/j.issn.1000-8578.2014.09.016
引用本文: 周然, 王峰, 庞丽娜, 曹蕾, 樊青霞. 塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌的临床观察[J]. 肿瘤防治研究, 2014, 41(09): 1031-1035. DOI: 10.3971/j.issn.1000-8578.2014.09.016
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ZHOU Ran, WANG Feng, PANG Lina, CAO Lei, FAN Qingxia. Clinical Observation of Celecoxib Combined with Pemetrexed Plus Carboplatin as a First-line Therapy for Advanced Pulmonary Adenocarcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 1031-1035. DOI: 10.3971/j.issn.1000-8578.2014.09.016
Citation: ZHOU Ran, WANG Feng, PANG Lina, CAO Lei, FAN Qingxia. Clinical Observation of Celecoxib Combined with Pemetrexed Plus Carboplatin as a First-line Therapy for Advanced Pulmonary Adenocarcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 1031-1035. DOI: 10.3971/j.issn.1000-8578.2014.09.016
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塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌的临床观察

  • 450052 郑州，郑州大学第一附属医院肿瘤科

详细信息
    作者简介:

    周然（1990-），女，硕士在读，主要从事恶性肿瘤的综合治疗

  • 中图分类号: R734.2

Clinical Observation of Celecoxib Combined with Pemetrexed Plus Carboplatin as a First-line Therapy for Advanced Pulmonary Adenocarcinoma

  • Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou450052, China

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    摘要
  • 摘要: 目的 评价塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌的疗效及安全性。方法 将43例符合标准的晚期肺腺癌患者随机分为A、B两组。A组22例采用塞来昔布联合培美曲塞和卡铂治疗，21 天为1周期，口服塞来昔布直至疾病进展或出现严重不良反应；B组21例只采用培美曲塞和卡铂治疗，21天为1周期。每2周期评价疗效，每天监测不良反应。结果 A组和B组的缓解率(RR)分别为40.90% （9/22）和38.10%（8/21），疾病控制率（DCR）分别为86.37%（19/22）和85.72%（18/21），两者比较差异无统计学意义（P=0.863）。中位无疾病进展时间（mPFS）分别为6.97月和6.37月，中位总生存时间（mOS）分别为14.8月和11.3月，差异均无统计学意义（P= 0.294，P=0.436）。A组1年总生存率为B组的两倍，但差异仍无统计学意义（21.10% vs. 10.00%，P=0.339）。A组生活质量（QOL）的改善明显高于B组（77.27% vs. 42.86%，P=0.031），两组不良反应发生率相似（P＞0.05）。结论 塞来昔布联合培美曲塞和卡铂一线治疗晚期肺腺癌未能提高疾病控制率，但能明显改善患者生活质量，不良反应发生率无增加，有一定临床应用价值，值得进一步研究。

     

    Abstract: Objective To evaluate the efficacy and toxicity of celecoxib(CXB) combined with pemetrexed(PEM) plus carboplatin(CBP) as a first-line therapy for advanced pulmonary adenocarcinoma. Methods Forty-three eligible patients were randomly assigned into two groups. In Group A, 22 patients were treated with CXB combined with PEM plus CBP regimen; in Group B, 21 patients were treated with PEM plus CBP alone. PEM and CBP were repeated every 3 wk, whereas CXB was continued with no interruption until the progression of disease or serious adverse events occurred. The efficacy was evaluated every 2 cycles and adverse reactions were observed every day. Results There was no significant difference in the remission rate (RR) or disease control rate (DCR) between Group A and Group B (40.90% vs. 38.10%, 86.37% vs. 85.72%, P=0.863). The median progression free survival time(mPFS) and the median overall survival time (mOS) in Group A were higher than those in Group B(6.97 m vs. 6.37 m, 14.8 m vs. 11.3 m), but there was no statistically significant difference (P= 0.294, P=0.436). The one-year OS rate in Group A was two times higher than that in Group B, with no statistically significance unexpectedly(21.10% vs. 10.00%, P=0.339). Improved quality of life (QOL) in Group A was significantly higher than that in Group B(77.27% vs. 42.86%，P=0.031), while toxicity rates were similar (P>0.05). Conclusion Although CXB combined with PEM plus CBP as a first-line therapy for advanced pulmonary adenocarcinoma couldn't improve the DCR, it could significantly improve the QOL without any increase of toxicity incidence. Therefore, the therapy is valuable to some degree in the clinical application and further study is needed.

     

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  • [1] Visbal AL, Leighl NB, Feld R, et al. Adjuvant chemotherapy for early-stage non-small cell lung cancer[J]. Chest,2005,128(4):2933 -43.
    [2] Scagliotti GV, Parikh P, von Pawel J, et al. Phase Ⅲ study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer[J]. J Clin Oncol, 2008,26(21):3543-51.
    [3] Ma J, Huo JG. Recent progress in anti-tumor effect of Celecoxib[J]. Xian Dai Zhong Liu Yi Xue,2012,20(5):1059-61.[马骏, 霍介格. 塞来昔布抗肿瘤作用研究进展[ J ] . 现代肿瘤 学,2012,20(5):1059-61.]
    [4] Benoit V, de Moraes E, Dar NA, et al. Transcriptional activation of cyclooxygenase-2 by tumor suppressor p53 requires nuclear factor-kappaB[J]. Oncogene, 2006, 25(42):5708-18.
    [5] Harris RE. Cyclooxygenase-2 ( cox-2) and the inflammogenesis of cancer[J]. Subcell Biochem,2007,42: 93-126.
    [6] Liu H, Yang Y, Xiao J, et al. COX-2-mediated regulation of VEGF-C in association with lymphangiogenesis and lymph node metastasis in lung cancer[J]. Anat Rec (Hoboken), 2010, 29 3(11):1836-46.
    [7] Haynes A, Shaik MS, Chatterjee A, et al. Formulation and evaluation of aerosolized celecoxib for the treatment of lung cancer[J]. Pharm Res, 2005, 22(3):427-39.
    [8] Koch A, Bergman B, Holmberg E, et al. Effect of celecoxib on survival in patients with advanced non-small cell lung cancer: a double blind randomised clinical phase Ⅲ trial (CYCLUS study) by the Swedish Lung Cancer Study Group[J]. Eur J Cancer, 2011, 47 (10):1546-55.
    [9] Liu CH, Bao HG, Ge YL, et al. Celecoxib inhibits insulin-like growth factor 1 induced growth and invasion in non-small cell lung cancer[J]. Oncol Lett, 2013, 5(6):1943-7.
    [10] Gasparini G, Meo S, Comella G, et al. The combination of the selective cyclooxygenase-2 inhibitor celecoxib with weekly paclitaxel is a safe and active second-line therapy for non-small cell lung cancer: a phase Ⅱ study with biological correlates[J]. Cancer J, 2005, 11(3):209-16.
    [11] Nugent FW, Mertens WC, Graziano S, et al. Docetaxel and cyclooxygenase-2 inhibition with celecoxib for advanced non-small cell lung cancer progressing after platinum-based chemotherapy: a multicenter phase Ⅱ trial[J]. Lung Cancer, 2005, 48 (2):267-73.
    [12] Schneider BJ, Kalemkerian GP, Kraut MJ, et al. Phase Ⅱ study of celecoxib and docetaxel in non-small cell lung cancer (NSCLC) patients with progression after platinum-based therapy[J]. J Thorac Oncol, 2008, 3(12):1454-9.
    [13] Gadgeel SM, Wozniak A, Ruckdeschel JC, et al. Phase Ⅱ study of docetaxel and celecoxib, a cyclooxygenase-2 inhibitor, in elderly or poor performance status (PS2) patients with advanced nonsmall cell lung cancer[J]. J Thorac Oncol, 2008, 3(11):1293-300.
    [14] Fidler MJ, Argiris A, Patel JD, et al. The potential predictive value of cyclooxygenase-2 expression and increased risk of gastrointestinal hemorrhage in advanced non-small cell lung cancer patients treated with erlotinib and celecoxib[J]. Clin Cancer Res,2008, 14(7):2088-94.
    [15] Edelman MJ, Watson D, Wang X, et al. Eicosanoid modulation in advanced lung cancer: cyclooxygenase-2 expression is a positive predictive factor for celecoxib + chemotherapy--Cancer and Leukemia Group B Trial 30203[J]. J Clin Oncol, 2008, 26 (6):848-55.
    [16] Groen HJ, Sietsma H, Vincent A, et al. Randomized, placebocontrolled phase Ⅲ study of docetaxel plus carboplatin with celecoxib and cyclooxygenase-2 expression as a biomarker for patients with advanced non-small-cell lung cancer: the NVALT-4 study[J]. J Clin Oncol, 2011, 29(32):4320-6.
    [17] Lei JH,Hong T, Zeng JZ.Clinical observation of cyclooxygenase-2 inhibitor celecoxib combined with oxycontin in treatment of moderate and severe cancer pain[J]. Lin Chuang Wu Zhen Wu Zhi, 2013,26(7):83-5. [雷俊华,洪涛,曾江正. 塞来昔布 联合奥施康定治疗中重度癌痛的临床观察[J]. 临床误诊误 治,2013,26(7):83-5.]
    [18] Dong XF, Hu XY, Du FM, et al. The efficacy of oxycontin combined with celecoxib in the treatment for cancer pain with moderate to severe degree[J].Zhong Liu Xue Za Zhi, 20 13,19(8):654-6. [董小芳,胡晓燕,杜方民,等. 奥施康定 联合塞来昔布治疗中重度癌痛的疗效分析[ J ] . 肿瘤学杂 志,2013,19(8):654-6.]
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  • 刊出日期:  2014-09-24

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