摘要
目的 探讨肺小细胞未分化癌 (SCLC)综合治疗的疗效及影响预后的因素。方法 对12 6 0例SCLC患者 (局限期 732例 ,广泛期 5 0 0例 ,无分期 2 8例 )进行分组治疗 ,其中化疗 +放疗组 5 5 3例 ,化疗 +放疗 +化疗组 35 5例 ,放疗 +化疗组 97例 ,单纯化疗组 12 6例 ,单纯放疗组 6 4例 ,手术 +化疗 +放疗组 6 5例。局限期患者接受 2～ 4个周期化疗 ,化疗方案有COMC、COMP、COMVP和CE CAP ;放疗 4 0～ 70Gy 4～ 7周 ,照射野包括原发灶、同侧肺门、相应纵隔和双侧锁骨上。广泛期患者以化疗为主 ,姑息放疗。结果 全组CR率 2 6 .7% ,PR率 5 2 .3% ,总有效率 79.0 %。局部复发率 5 8.8% ,远处转移率 6 1.5 %。 1,3,5年生存率分别为 5 0 .2 %、14 .7%和 11.7% ,中位生存期 12个月。经单因素和多因素分析显示 ,治疗年代、性别、年龄、分期和治疗方法均有统计学意义 (P <0 .0 5 )。化疗 +放疗 +化疗组的疗效好于化疗 +放疗组 ,但差异无显著性。结论 对SCLC患者应争取早诊断早治疗 ,局限期患者应尽量争取以手术为主的综合治疗。早放疗稍好于晚放疗。
Objective To evaluate the efficacy of combined modality treatment and determine the prognostic factors for small cell lung cancer (SCLC). Methods From January 1974 to December 1995, 1 260 patients with SCLC treated were retrospectively evaluated, with limited lesions in 732 patients, extensive lesions in 500 and stage unrecorded in 28. 553 patients were alloted into chemotherapy + radiotherapy (C+R) group, 355 into C+R+C group, 97 into R+C group, 126 into C group, 64 into R group and 65 into surgery (S+C+R) group. Patients with limited leisons received 2-4 cycles of chemotherapy including COMC, COMP, COMVP and CE-CAP. Radiotherapy was given to a dose of 40-70 Gy/4-7w. Radiation portals for patients with limited leisons encompassed the primary tumor, hilar lymphatic drainage areas, partial mediastinum and bilateral supraclavicular regions. Patients with extensive lesions mainly received chemotherapy with or without palliative irradiation. Results The overall CR and PR rates were 26.7% and 52.3%. Local recurrence and distant metastasis rates were 58.8% and 61.5%. The 1-, 3- and 5-year survival rates were 50.2%, 14.7% and 11.7%, with median survival time of 12 months. The era, sex, age, tumor stage and treatment modality were all significant prognostic factors by both uni-variate and multi-variate analyses (P<0.05). The result of S+C+R rated the best among these modalities and the result of C+R+C was superior to C+R, though the difference of which was not significant. Conclusion Surgical resection should be considered as one part of comprehensive therapy for small cell lung cancer patients with limited lesions whenever possible. On top of routine chemotherapy early administration of radiotherapy is advisable.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2002年第6期602-604,共3页
Chinese Journal of Oncology
关键词
肺小细胞未分化癌
综合治疗
肺肿瘤
药物疗法
放射疗法
SCLC
Lung neoplasms/drug therapy
Lung neoplasms/ radiotherapy
Carcinoma, small cell/drug therapy
Carcinoma, small cell/radiotherapy
Combined modality therapy
