摘要
目的 探讨广泛期SCLC患者不同转移部位对预后的影响。方法 回顾分析本院2011—2015年间收治的经病理学或细胞学诊断的广泛期SCLC患者322例,其中原发病灶伴远处器官转移246例,原发病灶伴非区域淋巴结转移76例。转移累及单器官261例,累及多器官61例。322例患者绝大多数接受EP、CE方案化疗,187例接受胸部3DRT。采用Kaplan-Meier法计算生存率,Logrank法比较组间生存差异,Cox模型多因素预后分析。结果 全组中位生存期和1、2年OS分别为11.7个月和47.9%、19.5%;转移累及单器官者分别为12.4个月和52.5%、21.9%,转移累及多器官者分别为8.9个月和30.5%、11.2%（P=0.014）。单器官转移中肝转移预后最差,中位生存期仅为8.5个月,非区域淋巴结转移预后最好,中位生存期为14.5个月（P=0.001）;除去肝转移以外单器官转移生存差异无统计学意义（P=0.139）。多器官转移中伴肝转移和伴骨转移预后最差（P=0.016、0.006）,而有无脑转移对广泛期SCLC多器官转移患者预后影响不大（P=0.995）。单纯肝转移和多器官转移预后无明显差异（P=0.862）。结论 广泛期SCLC患者初诊时单器官转移累及肝脏对预后有影响且预后最差;多器官转移伴肝转移以及伴骨转移预后最差,而有无脑转移对预后影响不大。转移一旦累及肝脏,单器官受累和多器官受累生存无明显差异。
Objective To investigate the effects of different metastatic sites on the prognosis of extensive-stage small cell lung cancer （SCLC）. Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive-stage SCLC （stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer） who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non-regional lymph node metastasis;261 had single-organ metastasis and 61 multi-organ metastases. Survival rates were calculated using the Kaplan-Meier method. Between-group comparison of the survival was made by the log-rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time （MST） was 11.7 months;1-and 2-year overall survival （OS） rates were 47.9% and 19.5%, respectively. The patients with single-organ metastasis had significantly longer MST and significantly higher 1-and 2-year OS rates than the patients with multi-organ metastases （12.4 vs. 8.9 months;52.5% vs. 30.5%;21.9% vs. 11.2%;P=0.014）. In the patients with single-organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8.5 months, while those with non-regional lymph node metastasis had the best prognosis with a MST of 14.5 months （P=0.001）;there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver （P=0.139）. In the patients with multi-organ metastases, those with liver metastasis and bone metastasis had the worst prognosis （P=0.016,0.006）;there was no significant relationship between brain metastasis and the prognosis of extensive-stage SCLC with multi-organ metastases （P=0.995）. There was no significant difference in the prognosis between those with liver metastasis only and multi-organ metastases （P=0.862）. Conclusions Liver metastasis p
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2017年第1期17-21,共5页
Chinese Journal of Radiation Oncology
关键词
癌
小细胞肺/放射疗法
癌
小细胞肺/化学疗法
远处转移
预后
Carcinoma,small cell lung/radiotherapy
Carcinoma,small cell lung/radiotherapy
Distant metastasis
Prognosis
