| Summary: | Objective To investigate the effects of platinum-based first-line chemotherapy combined with irinotecan versus with etoposide on brain metastasis of small cell lung cancer patients (SCLC). Methods A retrospective analysis was carried out in 126 SCLC patients without brain metastases admitted to our hospital from November 2011 to July 2018, including 84 patients receiving irinotecan chemotherapy in the first line (IP group), and 42 patients undergoing etoposide treatment in the first line (EP group), both based on platinum treatment. Objective response rate (ORR), disease control rate (DCR), and median progression-free survival (PFS), and cumulative incidence of central nervous system (CNS) and non-CNS progression after first-line treatment were compared between the 2 groups. Results For the IP group and the EP group, the ORR were 79.8% and 76.2%, respectively (P=0.645), and the DCR was 89.3% and 92.9%, respectively (P=0.748). The median PFS was 7.500±0.779 (5.974~9.026) months in the IP group, and 5.500±0.648 (4.230~6.770) months in the EP group, and statistical difference was seen between them (P=0.015). Compared with the EP group, the risk ratios of brain metastasis in IP patients with limited and extensive stages of SCLC were 0.270 (95%CI: 0.096~0.760, P=0.013) and 0.914 (95%CI: 0.281~2.973, P=0.881). In 3 months after treatment, the cumulative incidence of brain metastases in patients with limited stage was lower in the IP group than the EP group, and the incidence at 1 year was 14.3% and 31.8%, respectively. Conclusion IP chemotherapy delays the brain metastasis of SCLC patients when compared with EP treatment.
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