全身化疗联合局部放疗对广泛期小细胞肺癌患者生存期的影响

摘要

目的：评价全身化疗联合局部放疗对广泛期小细胞肺癌（extensive stage small cell lung cancer，ES-SCLC）患者生存期的影响。方法：回顾性分析46例 ES-SCLC 患者临床资料，根据是否接受转移灶局部治疗、原发灶放疗及全脑预防性照射治疗（prophylactic cranial irradiation，PCI），比较其临床特征及生存结果。结果：单部位、多部位及未行转移灶局部治疗患者的中位生存期（median survival time，MST）分别为12．1个月、18．5个月和9．5个月；限期性、择期性局部治疗及未行转移灶局部治疗患者的 MST分别为10．7个月、15．8个月和9．1个月，总生存期（overall survival，OS），比较差异有统计学意义（P ＜0.01）。放化疗与单纯化疗者 MST分别为13．7个月和8．7个月；行 PCI者与未行 PCI者 MST分别为18．4个月和10．1个月， OS 比较差异有统计学意义（P＜0．01）。Cox多因素回归分析显示，转移灶局部治疗、原发灶放疗及 PCI 是 ES-SCLC 患者的保护性独立预后因素（P＜0．01）。结论：在全身化疗基础上行转移灶局部治疗、原发灶放疗及 PCI均能延长 ES-SCLC 患者生存期。%Objective:To evaluate the influence of general chemotherapy combined with local radiotherapy in the treatment of patients with extensive stage small cell lung cancer (ES-SCLC).Methods:Retrospective analysis the clinical data of 46 patients with ES-SCLC,and their clinical characters and survival outcomes were compared according to whether they received local treatment for me-tastases,radiotherapy for primary nidi and prophylactic cranial irradiation (PCI).Results:The median survival time (MST)in patients with single and multiple local radiotherapy and those without local radiotherapy for metastases was 12.1 months,18.5 months and 9.5 months respectively.The MST in patients with local treatment in limited time and selective time and those without local radiotherapy for metastases was 10.7 months,15.8 months and 9.1 months respectively,and it was significant difference when compared with the overall survival (OS)(P<0.01).MST in patients with radiochemotherapy and single chemotherapy was 13.7 months and 8.7 months respec-tively.MST in patients with and without PCI was 18.4 months and 10.1 months respectively,and there was significant difference in the comparison with overall survival (OS)(P<0.01).Cox multivariate regression analysis showed that local treatment for metastases,ra-diotherapy for primary nidi and application of PCI were protective independent prognostic factors for patients with ES-SCLC (P<0. 01).Conclusion:On the basis of systemic chemotherapy,the local treatment of chemotherapy,primary radiotherapy and PCI can pro-long the survival of patients with ES-SCLC.