CAJ | 학술논문

目的：探讨术后放疗对早期SCLC预后影响。方法回顾分析我院1997—2010年临床分期为T1?2 N0 M0期且行根治性切除术的71例SCLC患者临床资料，31例术后放疗，55例术前或术后化疗。 Kaplan?Meier法计算LR率、远处转移率及生存率并Logrank法检验及单因素预后分析，Cox模型多因素预后分析。结果5年样本数32例，5年OS率及LR率分别为52％和22％，术后是否放疗对生存无影响（ P＝0?524）。对于术后N （?）患者行放疗与未行放疗者中位OS分别为47?3个月与96?8个月（ P＝0?561），5年LR率分别为39％与23％（ P＝0?934）。对于术后N （＋）患者行放疗者中位生存明显高于未行放疗者（66?7、34?6个月，P＝0?016），行放疗者5年LR率亦明显低于未行放疗者（5％、75％，P＝0?004）。全组患者远处转移率为30％，术后放疗与否对患者远处转移率无影响（ P＝0?576）。结论术后放疗明显降低了术后N （＋） SCLC患者LR率并提高了生存，而对N （?）患者反而有降低生存趋势，建议术后N （＋）的SCLC患者行术后放疗。
목적：탐토술후방료대조기SCLC예후영향。방법회고분석아원1997—2010년림상분기위T1?2 N0 M0기차행근치성절제술적71례SCLC환자림상자료，31례술후방료，55례술전혹술후화료。 Kaplan?Meier법계산LR솔、원처전이솔급생존솔병Logrank법검험급단인소예후분석，Cox모형다인소예후분석。결과5년양본수32례，5년OS솔급LR솔분별위52％화22％，술후시부방료대생존무영향（ P＝0?524）。대우술후N （?）환자행방료여미행방료자중위OS분별위47?3개월여96?8개월（ P＝0?561），5년LR솔분별위39％여23％（ P＝0?934）。대우술후N （＋）환자행방료자중위생존명현고우미행방료자（66?7、34?6개월，P＝0?016），행방료자5년LR솔역명현저우미행방료자（5％、75％，P＝0?004）。전조환자원처전이솔위30％，술후방료여부대환자원처전이솔무영향（ P＝0?576）。결론술후방료명현강저료술후N （＋） SCLC환자LR솔병제고료생존，이대N （?）환자반이유강저생존추세，건의술후N （＋）적SCLC환자행술후방료。
Objective To investigate the impact of postoperative radiotherapy ( PORT) on the prognosis of early?stage small?cell lung cancer ( SCLC) . Methods The clinical data of 71 patients who were clinically diagnosed with stage T1?2 N0 M0 SCLC and underwent radical resection surgery in our hospital from 1997 to 2010 were retrospectively analyzed. Thirty?one patients received PORT, and fifty?five patients received preoperative or postoperative chemotherapy. The locoregional recurrence ( LRR ) , distant metastasis, and overall survival ( OS) rates were calculated using the Kaplan?Meier method. The log?rank test was used for survival difference analysis and univariate prognostic analysis. The multivariate prognostic analysis was made by the Cox regression model. Results The 5?year sample size was 32. The 5?year OS and LRR rates were 52% and 22%, respectively. PORT had no significant impact on OS rate ( P=0?524). There were no significant differences in median OS and 5?year LRR rates between node?negative patients treated with and without PORT (47?3 vs. 96?8 months, P=0?561;39% vs. 23%, P=0?934). In the node?positive patients, patients treated with PORT had a significantly higher median OS rate and a significantly lower 5?year LRR rate than those treated without PORT ( 66?7 vs. 34?6 months, P=0?016;5% vs. 75%, P=0?004) . The distant metastasis rate was 30% in all patients, and PORT had no significant impact on the distant metastasis rate ( P=0?576) . Conclusions PORT significantly reduces LRR rate and improves OS rate in node?positive patients with SCLC. However, it slightly reduces OS rate in node?negative patients. Therefore, PORT is recommended for node?positive patients with SCLC.