72例局限期小细胞肺癌放疗加入时机的选择  

The ODtional Time of Radiotherapy for Limited-stase Small Cell Lune Cancer

作　　者：王世秀[1] 关勇[1] 袁智勇[1] 宋勇春[1] 马青山[1] 王平[1] 

机构地区：[1]天津市肿瘤防治重点实验室 天津市肺癌诊治中心 天津医科大学附属肿瘤医院放疗科,天津市300060

出　　处：《中国肿瘤临床》2009年第8期195-198,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨局限期小细胞肺癌放疗在序贯/交替放化疗中加入的最佳时间选择。方法:回顾性分析72例局限期小细胞肺癌患者,选取化疗开始后的6周、9周、12周为放疗加入的时间节点,在各时间节点前加入放疗为早期放疗组,反之为晚期放疗组。所有患者均接受普通放射治疗,1次/天、1.8-2.0Gy/次、5次/周;化疗方案主要为CE、EP或与cAP交替治疗。结果:共随访6～76个月(中位随访时间24个月) 时间节点为6周、9周、12周的早期放疗组有效率分别为71.4%、82.8%、87.5%,晚期放疗纽的有效率分别为85.5%、82.5%和75.9%,早、晚期放疗纽无显著差异(P>0.05);各时间节点早、晚期放疗组的1、3、5年生存率无显著差异(P>0.05)。6周、9周、12周早期放疗组中位生存期分别为21、28、25个月,晚期放疗组中位生存期分别为24、23、23个月,均无显著性差异(P>0.05) 6周、9周早期放疗组的无进展生存期较晚期放疗组有增加趋势(P=0.165和P=0.099),12周早期放疗组的无进展生存期明显优于晚期放疗组(P=0.004)结论:对于放疗方式为常规放疗的序贯/交替放化疗,早期加入放疗未能提高总生存期,但有增大无进展生存期的趋势,提示早期加入放疗的优势,尚需要进一步前瞻性研究。Objective： To investigate the optional time of radiotherapy in sequential or alternating radio-chemotherapy for limited-stage small cell Jung cancer （LS-SCLC）. Methods： Seventy-two patients with LS-SCLC were analyzed retrospectively and were divided into early and late radiotherapy groups according to the intervention time with the cutoff time point of 6 weeks, 9 weeks and 12 weeks after the beginning of chemotherapy, respectively. All of the patients received conventional radiotherapy： once daily, 1.8-2.0Gy every time, 5 times every week. The chemotherapy regimens mainly included CE, EP or CE plus EP with CAP alternatively, etc. Results： The follow-up time ranged from 6 to 76 months, with the median time of 24 months. For the early radiotherapy groups with the cutoff point of 6, 9 and 12 weeks, the response rates were 71.4%, 82.8% and 87.5%, respectively. For the late radiotherapy groups, the response rates were 85.5%, 82.5% and 75.9%, respectively. The differences in response rate were significant between the two groups （P=0.05）. For the early and the late radiotherapy groups with each cutoff point, the 1-, 3- and 5-year survival rates were not significantly different （P=0.05）. In addition, the median overall survival with cutoff of 6, 9 and 12 weeks were 2.1, 28 and 25 months in the early radiotherapy group, and were 24, 23 and 23 months in the late radiotherapy group, with no significant difference between the two groups （P=0.05）. On the contrary, the progression-free survival in the early radiotherapy group with the cutoff point of 6 and 9 weeks was better than that in the late group （P=0.165 and P=0.099）. The progression-free survival in the ealry radiotherapy group before 12 weeks of chemotherapy was better than that in the late group （P=0.004）. Conclusion： Early radiotherapy could not bring significant benefits for overall survival in sequential or alternating radio-chemotherapy with the conventional radiotherapy form. However, the progression-free survival could be eleva

关 键 词：小细胞肺 癌 放射治疗 化学治疗 

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