中华放射医学与防护杂志

臧婉娜,苏景伟,祝淑钗,等.局限期小细胞肺癌不同局部治疗方式的比较研究[J].中华放射医学与防护杂志,2017,37(1):40-44.Zang Wanna,Su Jingwei,Zhu Shuchai,et al.A comparative study of resection plus chemotherapy and chemoradiotherapy in limited-stage small cell lung cancer[J].Chin J Radiol Med Prot,2017,37(1):40-44

局限期小细胞肺癌不同局部治疗方式的比较研究

A comparative study of resection plus chemotherapy and chemoradiotherapy in limited-stage small cell lung cancer

投稿时间：2016-06-06

DOI：10.3760/cma.j.issn.0254-5098.2017.01.008

中文关键词: 局限期小细胞肺癌手术联合化疗放疗联合化疗预后

英文关键词:Limited-disease Small cell lung cancer Resection plus chemotherapy Chemoradiotherapy Prognostic

基金项目:

作者	单位	E-mail
臧婉娜	053000 衡水市第四人民医院肿瘤科
苏景伟	050011 石家庄, 河北医科大学第四医院放疗科
祝淑钗	050011 石家庄, 河北医科大学第四医院放疗科	sczhu1965@163.com
赵彦	050011 石家庄, 河北医科大学第四医院放疗科
宋春洋	050011 石家庄, 河北医科大学第四医院放疗科
许金蕊	050011 石家庄, 河北医科大学第四医院放疗科

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中文摘要:

目的比较局限期小细胞肺癌手术联合化疗与放疗联合化疗的预后生存，并分析其相关影响因素。方法回顾性分析2006—2011年230例局限期小细胞肺癌临床资料，其中手术联合化疗（S+C）组121例，放疗联合化疗（R+C）组109例，采用2010版AJCC肺癌TNM分期标准将局限期小细胞肺癌进行分期，两组比较均采用术前临床分期，Kaplan-Meier法进行生存分析。结果全组1、3、5年生存率分别为87.0%、38.9%、25.4%，中位生存期为26个月；S+C和R+C两组中Ⅰ+Ⅱ期患者的1、3、5年生存率分别为92.6%、63.2%、47.3%和76.2%、42.9%、30.6%，差异有统计学意义（χ²=7.851，P<0.05）；两组中Ⅲ_A期患者的1、3、5年生存率分别为88.5%、26.9%、10.6%和86.0%、25.1%、25.1%（P>0.05）。单因素分析显示，肿瘤部位、T分期、N分期、TNM分期、化疗周期数、治疗方式对生存产生明显影响（RR＝1.735，P<0.05）；多因素分析显示，TNM分期是影响患者生存的独立因素。结论手术联合化疗有可能使早期小细胞肺癌患者生存获益，而Ⅲ期患者应接受放化疗综合治疗；TNM分期仍然是影响局限期小细胞肺癌预后的独立性因素。

英文摘要:

Objective The aim of this study was to evaluate the prognosis of resection followed by chemotherapy compared with chemoradiotherapy for limited-stage small cell lung cancer.Methods The clinical data of 230 limited-stage small cell lung cancer patients with curative treatment between January 2006 and December 2011 were retrospectively analyzed. All patients divided to two group:the resection plus chemotherapy (S+C) and chemoradiotherapy (R+C). And the prognostic factors were further analyzed with limited stage small cell lung cancer. The Kaplan-Meier method was used for the survival analysis. Results The overall survival rates of 1-year, 3-year and 5-year were 87.0%, 38.9%, 25.4%, respectively and the media survival time (MST) 26.0 months. When patients were stratified by clinical stage Ⅰ+Ⅱ, the 1-year, 3-year and 5-year overall survival rates of S+C group and R+C group were 92.6%, 63.2%, 47.3% and 76.2%, 42.9%, 30.6%, respectively (χ²=7.851,P<0.05), while those were 88.5%, 26.9%, 10.6% and 86.0%, 25.1%, 25.1%, respectively in stage Ⅲ_A with no significant difference(P>0.05). In univariate analysis, tumor location, tumor stage, lymph node metastasis, TNM stage, the cycle of chemotherapy, treatment modalities were significantly associated with survival (RR=1.735, P<0.05).The multivariate analysis only showed TNM stage were independent factors of prognosis. Conclusions The results suggested that resection plus chemotherapy could improve the prognosis of early-stage(stageⅠ+Ⅱ) small cell lung cancer, but patients in Ⅲ_A stage should received the definitive chemoradiotherapy. The TNM stage was still the independent factor of prognosis.

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