摘要
目的:探讨局限期小细胞肺癌接受综合治疗后的疗效及其预后因素。方法:回顾性分析2006年1月至2008年6月于河北医科大学第四医院综合治疗的158例局限期小细胞肺癌临床资料,所有病例均经病理证实,接受化疗者146例(92.4%),化疗方案多为EP、EC、TP、CAP,平均化疗5个周期(1～17个);接受放疗者120例(75.9%),平均等效剂量54Gy(20～79.25 Gy);接受手术者49例(31.0%),其中楔形切除2例、段切除3例、叶切除25例、全肺切除19例。综合治疗模式包括:放疗±化疗109例(69.0%)、手术±化疗38例(24.1%)、手术+放疗+化疗11例(6.9%)。采用Kaplan-Meier法计算生存率,采用Log-rank法进行单因素分析,多因素分析采用Cox比例风险模型筛选影响预后因素,P<0.05为差异具有统计学意义。结果:全组总有效率(CR+PR)86.7%,中位生存期24个月,1、3、5年生存率分别为76.3%、39.1%、36.4%。单因素分析显示临床分期、近期疗效、化疗、放疗、放疗等效剂量、手术对预后产生明显影响(P<0.05);多因素分析显示近期疗效、化疗、放疗等效剂量是影响患者预后的独立因素。结论:局限期SCLC综合治疗方案的优选还有待进一步研究。而采取多学科的综合治疗,有望进一步提高局限期SCLC的预后。
Objective： To evaluate the condition of limited-stage small-cell lung-cancer （ LD-SCLC ） patients after combined therapy. Methods： The medical data of 158 LD-SCLC patients treated with combined therapy between January 2006 and June 2008 were retrospectively analyzed. A total of 146 patients received chemotherapy, 120 received radiotherapy, and 49 underwent surgery. The combined therapies included radiotherapy ±chemotherapy, surgery ± chemotherapy, and surgery ＋ radiotherapy ＋ chemotherapy. The Kaplan-Meier estimation was used for the survival analysis. Results： The overall response rate （ CR ＋ PR ） was 86.7%. The median survival time was 24 months, and the 1-, 3-, and 5-year survival rates were 76.3%, 39.1%, and 36.4%, respectively. The short-term clinical effect and the chemotherapy and radiotherapy doses were the influential factors for prognosis. Conclusion： Combined therapy can achieve good results for LD-SCLC patients. Further study is needed to choose the best combined therapy model
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2012年第1期26-31,共6页
Chinese Journal of Clinical Oncology
关键词
小细胞肺癌
综合治疗
化疗
放疗
手术
生存率
Small-cell lung cancer
Combination therapy
Chemotherapy
Radiotherapy
Surgery
Survival rate
