摘要
156例广泛期小细胞肺癌(E—SCLC),伴血液转移灶占42.9%(67/156).以联合化疗为主,达缓解(RR)或稳定(S)(包括血行转移灶)≥3月者,予以局部放疗(RT)和/或脑预防放疗(PBI).CR+PR58.9%(5+87/156),中数生存期9月,≥1、≥2及≥3年生存率(SR)各为28.8%(45/156)、3.2%(5/156)及<1%(1/156).RR者之中数生存期(MSD)、≥1年SR,及SR优势均显著优于未达RR者(P<0.001、<0.02).与MSD、≥1年SR及SR优势均有关的因素有:骨和/或骨髓转移(与肝和/或脑转移对应)、CT+RT、CT+RT+PBI,及治后达RR.女性≥2年SR优于男性.‘ECOG’0～1级对总的SR优势有利(P<0.02).接受PBI者,脑转移明显低于PBI(-)者(P<0.005).本组经验:对广泛骨转移者,不应放弃治疗;对可耐受者,应争取RT和/或PBI治疗,确可改善SR及SR质量;分期手段应详尽、统一.应积累更多病例作较准确的多变量预后因素分析.
One hundred and fifty six patients with small cell lung cancer(SCLC) ,67 of which (42. 9%)had distant metastases were treated in our hospital mainly with combined chemotherapy. Some of the patients who' s diseases achieved CR, PR or stable disease for more than three months were followed by radiotherapy to the primary site. Some received prophylactic brain irradiation (FBI). The overall CR+PR rate was 58. 9% (5 + 87/156). Median survival time was 9 months and the≥1,≥2 and≥3 year survival rates were 28. 8%,3. 2%and ≤1% respectively. Brain metastatic rate was much lower in patients with PBI than that without (3. 6% VS 17. 6% ,P<0. 005). It was found that the MSD,≥ lyear SR and probability survival rate was improved in patients who received CT-f RT,or CT4-RT+PBI. Bone metas-tases was not a bad prognostic factor when compared with liver and brain metastases. It is likely to improve the prognosis bycombining several therapeutic methods in patients with E-SCLC.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
1994年第1期28-33,共6页
Chinese Journal of Clinical Oncology
关键词
癌
药物疗法
预后
肺肿瘤
Small cell lung caner(SCLC) Radiotherapy Prophylactic brain irradiation (PBI) Prognostic factor
