长春瑞滨联合异环磷酰胺三线以后治疗晚期非小细胞肺癌的疗效和不良反应

BACKGROUND AND OBJECTIVE: Patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) should be treated with first-line and second-line chemotherapy or target therapy according to the lung cancer guidelines. However, no recommended treatments are available after failure to these treatments. In our study, the efficacy and safety of combined chemotherapy of vinorelbine and ifosfamide as third-line therapy or beyond for advanced NSCLC was evaluated. METHODS: A total of 41 patients took a combination of vinorelbine and ifosfamide as third-line or above chemotherapy in Peking Union Hospital between May 2010 and May 2014. They were pathologically or cytologically confirmed as having locally advanced or metastatic NSCLC. Clinically measurable lesions existed, and Eastern Cooperative Oncology Group performance status ranged from 0 to 2. No serious complications were observed in the hematopoietic system, and liver and renal functions were normal. RESULTS: The 41 patients enrolled in this study were given 150 cycles of chemotherapy, of which 23 cycles (15.3%) were delayed or dose-adjusted. Results of the objective response evaluation showed that 3 cases had objective partial response (7.3%) and 25 cases were stable (61.0%). The median progression-free survival time was 5.5 months, and the median overall survival time was 10.5 months. Hematological toxicity was the most frequent adverse event. Grade 3/4 neutropenia had 10.7% occurrence; grade 3/4 white blood cell decrease had 8.7%; and grade 3/4 anemia had 8.7%. All adverse events were manageable, and no drug-related death was found. CONCLUSION: Vinorelbine and ifosfamide as third-line treatment and beyond of NSCLC were well tolerated. Most patients can benefit from this combined chemotherapy. A clinical trial with large samples is necessary to prove whether overall survival will.