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目的回顾性分析局限期小细胞肺癌的治疗情况,并评价不同治疗方式的疗效和预后因素。方法经病理和组织学证实的局限期小细胞肺癌234例,行化疗或化放疗的综合治疗,其中单纯化疗组22例,化疗+放疗组39例,化疗+放疗+化疗组173例。化疗以CE(PE)、CAP、CAV方案为主,一般疗程为4～6周期。放疗采用6MV-X线直线加速器,照射范围包括原发灶、肺门及同侧纵隔。先行前后对穿照射4周,然后改斜野避开脊髓补量2周,使总量达56～60Gy/5～6周。结果全组总的中位生存时间为19个月,1年生存率为76.5%,2年生存率为38.2%,3年生存率为25.3%,5年生存率为15.6%。化疗+放疗+化疗组的生存率明显高于化疗+放疗组和单纯化疗组,具有显著差异(P<0.001)。治疗方式和临床分期对预后产生明显影响(分别为P<0.001,P=0.001)。结论化疗+放疗+化疗的综合治疗对局限期小细胞肺癌的治疗取得较好的效果,临床分期及治疗方式对预后产生明显影响。
Objective To retrospectively analyze the treatment of small cell lung cancer and to evaluate the curative effect and prognostic factors of different treatment modalities. Methods 234 patients with localized small cell lung cancer confirmed by pathology and histology were treated with chemotherapy or chemoradiotherapy. Among them, 22 were chemotherapy alone, 39 received chemotherapy and radiotherapy, and 173 received chemotherapy and radiotherapy + chemotherapy. Chemotherapy with CE (PE), CAP, CAV program-based, the general course of treatment is 4 to 6 cycles. Radiotherapy using 6MV-X linear accelerator, irradiation range, including the primary tumor, hilar and ipsilateral mediastinum. Before and after the first wear on the wear 4 weeks, and then change the field to avoid spinal cord fill up 2 weeks, bringing the total amount of 56 ~ 60Gy / 5 ~ 6 weeks. Results The overall median survival time was 19 months. The 1-year survival rate was 76.5%, the 2-year survival rate was 38.2%, the 3-year survival rate was 25.3%, and the 5-year survival rate was 15.6%. The survival rates of chemotherapy + radiotherapy + chemotherapy group were significantly higher than those of chemotherapy + radiotherapy group and chemotherapy alone group (P <0.001). The treatment and clinical stage had a significant effect on the prognosis (P <0.001, P = 0.001, respectively). Conclusion The combination of chemotherapy + radiotherapy + chemotherapy has a good effect on the treatment of SCLC. The clinical staging and treatment methods have a significant effect on the prognosis.