CAJ | 학술논문

目的：探讨局限期小细胞肺癌（limited-disease small cell lung cancer，LSCLC）诱导化疗疗效是否会影响放疗时机的选择。方法：分析天津医科大学肿瘤医院2009年2月至2011年4月间诱导化疗后行放疗的148例LSCLC患者临床资料，根据RE-CIST标准将2～3个周期诱导化疗后的疗效分为完全缓解、部分缓解、病情稳定和疾病进展，化疗后有效包括完全缓解和部分缓解。根据诱导化疗后是否直接行放疗将患者分为早放疗组和晚放疗组。Kaplan-Meier法进行生存分析，组间差异采用Log-rank检验。结果：全组患者的中位生存期（overall survival，OS）为22.8个月，中位无进展生存期（progression-free survival，PFS）为13.0个月。早放疗组和晚放疗患者的中位OS分别为34.0个月和18.0个月（P=0.012），中位PFS分别为16.8个月和10.9个月（P=0.019）。两组分析发现，2～3个周期诱导化疗后有效的患者，早放疗组和晚放疗组的中位OS分别为36.9个月和22.8个月（P=0.043），PFS分别为19.4个月和11.7个月（P=0.011）；诱导化疗后无效的患者，两组的中位OS分别为18.0个月和9.5个月（P=0.015），中位PFS分别为12.4个月和10.3个月（P=0.566）。结论：局限期小细胞肺癌行2～3个周期诱导化疗后无论是否有效，都应该尽快开始放疗。
목적：탐토국한기소세포폐암（limited-disease small cell lung cancer，LSCLC）유도화료료효시부회영향방료시궤적선택。방법：분석천진의과대학종류의원2009년2월지2011년4월간유도화료후행방료적148례LSCLC환자림상자료，근거RE-CIST표준장2～3개주기유도화료후적료효분위완전완해、부분완해、병정은정화질병진전，화료후유효포괄완전완해화부분완해。근거유도화료후시부직접행방료장환자분위조방료조화만방료조。Kaplan-Meier법진행생존분석，조간차이채용Log-rank검험。결과：전조환자적중위생존기（overall survival，OS）위22.8개월，중위무진전생존기（progression-free survival，PFS）위13.0개월。조방료조화만방료환자적중위OS분별위34.0개월화18.0개월（P=0.012），중위PFS분별위16.8개월화10.9개월（P=0.019）。량조분석발현，2～3개주기유도화료후유효적환자，조방료조화만방료조적중위OS분별위36.9개월화22.8개월（P=0.043），PFS분별위19.4개월화11.7개월（P=0.011）；유도화료후무효적환자，량조적중위OS분별위18.0개월화9.5개월（P=0.015），중위PFS분별위12.4개월화10.3개월（P=0.566）。결론：국한기소세포폐암행2～3개주기유도화료후무론시부유효，도응해진쾌개시방료。
Objective:This study aims to analyze the relationship between the effect of induction chemotherapy and the timing of radiotherapy in limited-disease or limited-stage small-cell lung cancer (LSCLC). Methods: Data from 148 LSCLC patients who re-ceived induction chemotherapy and radiotherapy between January 2009 and December 2012 were retrospectively analyzed. The effect of two to three cycles of induction chemotherapy was evaluated according to the RECIST version 1.1, which includes complete re-sponse (CR), partial response (PR), stable disease, and progressive disease. CR and PR were used to calculate response rate. The pa-tients were divided into early and late groups based on immediate radiotherapy after two to three cycles of induction chemotherapy. The survival rate was analyzed using the Kaplan-Meier method. Log-rank test and Cox regression model were used to evaluate the influenc-ing factors of the survival rate. Results: The median overall survival (OS) and progression-free survival (PFS) were 22.8 and 13.0 months, respectively. The early and late radiotherapy groups exhibited OS of 34.0 and 18.0 months, respectively, and corresponding PFS of 16.8 and 10.9 months. In the subgroup analysis, for the patients who responded to the induction chemotherapy, the early and late radiotherapy groups showed median OS of 18.0 and 19.5 months, respectively, and corresponding PFS of 19.4 and 11.7 months. For the patients who had no response to the induction chemotherapy, the early and late radiotherapy groups exhibited median OS of 18.0 and 9.5 months, respectively, and corresponding PFS of 12.4 and 10.3 months. Conclusion:All LSCLC patients who received two to three cycles of induction chemotherapy should receive radiotherapy as soon as possible after chemotherapy, regardless of their response to the induction chemotherapy.