10年来局限期小细胞肺癌放化综合治疗模式及疗效分析  

Limited-stage small cell lung cancer treated with chemoradiotherapy: patterns of care and treatment outcomes—10 years' experience

作　　者：夏冰[1] 陈桂园[1] 蔡旭伟[1] 朱正飞[1] 赵快乐[1] 樊旼[1] 杨焕军[1] 吴开良[1] 王丽娟[1] 施学辉[1] 钱浩[1] 傅小龙[1] 

机构地区：[1]复旦大学附属肿瘤医院放疗科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2012年第1期42-46,共5页China Oncology

摘　　要：背景与目的:近20年来,局限期小细胞肺癌(limited-stage small cell lung cancer,LS-SCLC)放疗方面的进展推动了其综合治疗模式的改变。本研究旨在分析收治的LS-SCLC的放化综合治疗模式及疗效。方法:回顾性分析本院1997年1月—2006年12月收治的LS-SCLC患者的临床资料,入组标准为病理证实且接受根治性目的放疗的患者,就分期检查、放化疗模式及治疗效果进行总结分析。结果:本研究共入组220例患者。绝大部分患者治疗前接受了骨扫描和脑CT或MRI检查。96%的患者接受了诱导化疗,中位诱导化疗周期数为2。仅5%的患者接受了同步放化疗。三维适形放疗和适形调强放疗的比例为25%,中位放疗剂量为56 Gy(39～70 Gy),超分割放疗(每次1.4 Gy,每日2次)的比例为58%。接受脑部预防性放疗的比例为11%。全组中位生存期为23个月(95%CI:20～25个月),2和5年的生存率分别为46%和22%。结论:本院近10年来收治的LS-SCLC总体治疗效果同文献报道相近,分期检查也相对比较完善,但在治疗模式上,同步放化疗的应用比例较低,放疗早期参与和脑部预防性放疗的应用方面尚存在不足,在以后临床实践中有待提高。Background and purpose：Combined modalities treatment of limited-stage small cell lung cancer（LS-SCLC） had great progress due to the advance of radiation therapy in recent 20 years.This study was undertaken to analyze the practice process of chemoradiotherapy and to evaluate the outcomes in LS-SCLC treated in our center.Methods：The medical records of SCLC treated at our center between Jan.1997 and Dec.2006 were reviewed retrospectively.LS-SCLC patients were confirmed by pathological diagnosis,and were treated with definitive radiotherapy.The patterns of care and treatment outcomes were investigated.Results：We collected the data of 220 patients with LS-SCLC.Most of the patients received bone scan and brain CT/MRI in initial evaluation.Induction chemotherapy was delivered in 96% of the patients and the median was 2 cycle.Only 5% of the patients received concurrently chemotherapy during radiotherapy.Three-dimensional conformal radiotherapy and intensity modulated radiotherapy were used within 25% of the patients.The median radiation dose was 56 Gy（39-70 Gy）,hyperfractionated radiotherapy（1.4 Gy per fraction,twice daily） was used in 58% of the patients.Prophylactic cranial irradiation（PCI） was delivered in 11% of the patients.The median overall survival was 23 months（95%CI： 20-25 months）,and the 2-and 5-year overall survival rates were 46% and 22% respectively.Conclusion：The outcomes of LS-SCLC treated in our center were comparable to the results in literature.However,the percentage of the patients treated with concurrently chemoradiotherapy and PCI was low,and the time for radiotherapy should be early in clinical practice.

关 键 词：小细胞肺癌 放射疗法 诊疗模式 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]