中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2015年
5期
272-279
,共8页
吴頔%方健%聂鋆%戴玲%陈筱玲%张洁%胡维亨%韩金娣%马向娟%田广明%韩森%龙皆然%王洋
吳頔%方健%聶鋆%戴玲%陳篠玲%張潔%鬍維亨%韓金娣%馬嚮娟%田廣明%韓森%龍皆然%王洋
오적%방건%섭윤%대령%진소령%장길%호유형%한금제%마향연%전엄명%한삼%룡개연%왕양
肺肿瘤%放疗%全脑预防性照射治疗%局部治疗%生存期
肺腫瘤%放療%全腦預防性照射治療%跼部治療%生存期
폐종류%방료%전뇌예방성조사치료%국부치료%생존기
背景与目的化疗作为广泛期小细胞肺癌（extensive-stage small cell lung cancer, ES-SCLC）的主要治疗方法，其有效率高，但容易发生快速耐药。局部治疗作为姑息治疗方法，能够缓解局部症状和提高患者生活质量，但是能否延长生存期尚缺乏证据。本研究旨在分析在全身化疗基础上的局部放疗对ES-SCLC患者生存的作用与影响。方法回顾性分析302例ES-SCLC患者临床资料，采用Kaplan-Meier法及Cox多因素回归分析预后因素。结果全组患者中位无进展生存期（progression-free survival, PFS）4.4个月，中位生存期（median survival time, MST）10.4个月，1年生存率37.8%；2年生存率10.2%；3年生存率4.4%。原发灶放疗＋化疗组和单纯化疗组患者MST分别为14.3个月和8.2个月（P<0.01）；多处转移灶局部治疗、一处转移灶局部治疗和未行转移灶局部治疗患者MST分别为18.7个月、12.3个月和8.9个月（P<0.01）；主动性的转移灶局部治疗、被动性的转移灶局部治疗和未行转移灶局部治疗患者MST分别为16.0个月、10.9个月和9.4个月（P<0.01）；全脑预防性照射治疗（prophylactic cranial irradiation, PCI）和未行PCI患者MST分别为19.8个月和9.9个月（P<0.01）。原发灶放疗、转移灶局部治疗和PCI是ES-SCLC患者的独立预后因素（P<0.01）。结论原发灶放疗、转移灶局部治疗和PCI能够延长ES-SCLC患者生存期。
揹景與目的化療作為廣汎期小細胞肺癌（extensive-stage small cell lung cancer, ES-SCLC）的主要治療方法，其有效率高，但容易髮生快速耐藥。跼部治療作為姑息治療方法，能夠緩解跼部癥狀和提高患者生活質量，但是能否延長生存期尚缺乏證據。本研究旨在分析在全身化療基礎上的跼部放療對ES-SCLC患者生存的作用與影響。方法迴顧性分析302例ES-SCLC患者臨床資料，採用Kaplan-Meier法及Cox多因素迴歸分析預後因素。結果全組患者中位無進展生存期（progression-free survival, PFS）4.4箇月，中位生存期（median survival time, MST）10.4箇月，1年生存率37.8%；2年生存率10.2%；3年生存率4.4%。原髮竈放療＋化療組和單純化療組患者MST分彆為14.3箇月和8.2箇月（P<0.01）；多處轉移竈跼部治療、一處轉移竈跼部治療和未行轉移竈跼部治療患者MST分彆為18.7箇月、12.3箇月和8.9箇月（P<0.01）；主動性的轉移竈跼部治療、被動性的轉移竈跼部治療和未行轉移竈跼部治療患者MST分彆為16.0箇月、10.9箇月和9.4箇月（P<0.01）；全腦預防性照射治療（prophylactic cranial irradiation, PCI）和未行PCI患者MST分彆為19.8箇月和9.9箇月（P<0.01）。原髮竈放療、轉移竈跼部治療和PCI是ES-SCLC患者的獨立預後因素（P<0.01）。結論原髮竈放療、轉移竈跼部治療和PCI能夠延長ES-SCLC患者生存期。
배경여목적화료작위엄범기소세포폐암（extensive-stage small cell lung cancer, ES-SCLC）적주요치료방법，기유효솔고，단용역발생쾌속내약。국부치료작위고식치료방법，능구완해국부증상화제고환자생활질량，단시능부연장생존기상결핍증거。본연구지재분석재전신화료기출상적국부방료대ES-SCLC환자생존적작용여영향。방법회고성분석302례ES-SCLC환자림상자료，채용Kaplan-Meier법급Cox다인소회귀분석예후인소。결과전조환자중위무진전생존기（progression-free survival, PFS）4.4개월，중위생존기（median survival time, MST）10.4개월，1년생존솔37.8%；2년생존솔10.2%；3년생존솔4.4%。원발조방료＋화료조화단순화료조환자MST분별위14.3개월화8.2개월（P<0.01）；다처전이조국부치료、일처전이조국부치료화미행전이조국부치료환자MST분별위18.7개월、12.3개월화8.9개월（P<0.01）；주동성적전이조국부치료、피동성적전이조국부치료화미행전이조국부치료환자MST분별위16.0개월、10.9개월화9.4개월（P<0.01）；전뇌예방성조사치료（prophylactic cranial irradiation, PCI）화미행PCI환자MST분별위19.8개월화9.9개월（P<0.01）。원발조방료、전이조국부치료화PCI시ES-SCLC환자적독립예후인소（P<0.01）。결론원발조방료、전이조국부치료화PCI능구연장ES-SCLC환자생존기。
Background and objective Chemotherapy is a highly effcient primary treatment for extensive-stage small cell lung cancer (ES-SCLC). However, patients receiving such treatment are prone to develop drug resistance. Local treatment is palliative and thus can alleviate the local symptoms and improve quality of life, but limited evidence is available for prolonging survival. Hence, this study evaluated the role of local treatment in chemotherapy of patients with ES-SCLC. Methods A total of 302 ES-SCLC cases were enrolled in this retrospective study. Prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results Median progression-free survival (PFS) and median survival time (MST) of the patients were 4.4 and 10.4 months, respectively. 1-, 2-, and 3-year survival rates were 37.8%, 10.2%and 4.4%, correspondingly. hTe MST of the primary tumor radiotherapy plus chemotherapy group was 14.3 months, whereas that of the chemotherapy group was 8.2 months (P<0.01). hTe MSTs of multiple-site, single-site, and non-metastasis local treatments were 18.7, 12.3 and 8.9 months, respectively (P<0.01). hTe MSTs of initiative, passive, and non-metastasis local treatments were 16.0, 10.9 and 9.4 months, correspondingly (P<0.01). hTe MSTs of patients with prophylactic cranial irradiation (PCI) and those without PCI were 19.8 and 9.9 months, respectively (P<0.01). Primary tumor radiotherapy, metastasis local treat-ment, and PCI were independent prognostic factors for ES-SCLC. Conclusion Primary tumor radiotherapy, metastasis local treatment, and PCI can signiifcantly improve survival in patients with ES-SCLC.
