放射治疗在广泛期小细胞肺癌治疗中的影响  

Influence of Radiotherapy in the Treatment for Patients with Extensive Stages of Small Cell Lung Cancer(SCLC)

作　　者：陈东福[1] 吕纪马[1] 周宗枚[1] 王绿化[1] 张宏兴[1] 冯勤富[1] 梁军[1] 肖泽芬[1] 张世平[1] 张香茹[1] 殷蔚伯[1] 

机构地区：[1]中国医学科学院/中国协和医科大学肿瘤医院放射治疗科,100021

出　　处：《医学研究杂志》2006年第4期15-17,共3页Journal of Medical Research

摘　　要：目的探讨放射治疗在广泛期小细胞肺癌中的影响。方法与材料广泛期小细胞肺癌180例。原发病灶伴有对侧纵隔和(或)锁骨上淋巴结转移者48例,伴有远处转移132例。化疗+放疗142例,单纯化疗32例,单纯放疗6例。胸部放疗剂量:<50Gy33例,≥50Gy105例。脑部放疗剂量:30Gy/10次28例,40Gy/20次22例。结果全组近期疗效:CR13.3%(24/180),PR61.7%(111/180)。生存率:1年47.8%,2年17.2%,中位生存期10个月。化放疗组142例,化疗后疗效评价:CR4.9%,PR69.7%。放疗后症状缓解率及疗效评价:70%以上的病人呼吸道症状、上腔静脉压迫综合征、骨转移疼痛及脑转移症状和体征有不同程度缓解甚至消失。CR17.6%,PR65.5%。1年生存率52.8%,2年19.7%。中位生存期11个月。单纯化疗32例近期疗效评价:CR1例,PR19例,1年生存28.9%,2年7.8%,中位生存期6个月。结论放射治疗在广泛期小细胞肺癌治疗中起到了较好的缓解症状和体征、延长生存的作用。Objective To evaluate the effects of radiotherapy in the treatment for patients with extensive stages of small cell lung cancer （SCLC） . Methods From January 1996 to December 2002, 180 patients with ED-SCLC were treated, ofthem, 48 pafients were primary tumor with mediastinum and supraclavicular lymph node metastasis, 132 patients were primary tumor with distant metastasis. 142 patients were chemotherapy ＋ radiotherapy, 32 patients were chemotherapy alone, 6 patients were radiotherapy alone. 33 patients of the total dose was less than 50Gy, the total dose of 105 cases was more than 50Gy thoracic radiotherapy. The total dose with brain metastasis radiotherapy was 30 - 40Gy/10 - 20 fractions. Results The complete response and partial response of overall group were 13.3 % and 61.7 %. The 1 and 2- year survival rates were 47.8% and 17.2%, the median survival was 10 months. Chemotherapy ＋ radiotherapy group was 142 patients, CaR and PR after chemotherapy was 4.9% and 69.7%. The effectiveness of radiotherapy was as follows： More than 70% patients were palliative for the cough, hemoptysis, chest pain and dyspnea, superior vena cava syndrome, brain and bone metastasis symptoms to some exfend some syndromes even disapeared. The CR and PR were 17.6%, 65.5%. The 1 - and 2- year survival rotes were 52.8% and 19.7%, the median survival was 11 months. 32 patients of chemotherapy alone for 1 - and 2- year survival rates were 28.9% and 7.8%, the median survival was 6 months. Conclusion It is effective with radiotherapy to palliative symptoms and prolong survival in patients with extensive stage small cell lung cancer.

关 键 词：小细胞肺癌/放射疗法 小细胞肺癌/药物疗法 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]