A Retrospective Study Of The Efficacy And Toxicity Of IP Versus CAO As Salvage Treatment In Refractory Or Recurrent Small Cell Lung Cancer

Objective:There is no established standard second-line chemotherapy for the refractory or recurrent small cell lung cancer,although many regimens are available for clinical practice.This retrospective study aimed to evaluate the efficacy and safety of IP(irinotecan plus nedaplatin)and CAO(cyclophosphamide combined with epirubicin and vinorelbine)in the second-line treatment of small cell lung cancer.Methods:This study retrospectively analyzed 56 patients who diagnosed small cell lung cancer at Tianjin Medical University Cancer Institute and Hospital from January 2010 to November 2016.All patients were treated with IP or CAO as second-line regimes.The objective response rate(ORR)and disease control rate(DCR)were used to evaluate the short-term efficacy.The Kaplan-Meier method survival curves and Log-rank test were used to analysis the overall survival time(OS)and progressive survival(PFS).Prognostic factors of OS and PFS were estimated by the Cox's Regression-proportional hazards model.In addition,the safety of the two groups was evaluated.Results:Of the 56 patients,46 patients were eligible to evaluate the short-term efficacy.In the IP group and CAO group,the ORR were 24.1% and 23.5%,and the DCR were 58.6% and 29.4%,respectively.There was no statistically significant difference(P=1.000;P=0.056).The median PFS were 3.0 months in the IP group and 2.6 months in the CAO group.The median OS was 6.8 months and 7.1 months,respectively.No significant difference was observed between the two groups.Multivariate Cox analysis showed that the thoracic radiotherapy(P=0.034),ECOG PS(P=0.032)were independent prognostic factors.In the assessment of toxicity,the diarrhea incidence was higher in IP group(P=0.034).Conclusion:In the second-line treatment of recurrent small cell lung cancer,IP regimen did not show superiority to CAO regimen,but the incidence of diarrhea of IP regimen was higher.