32例晚期及术后复发肺肉瘤样癌患者的治疗及生存分析  

Outcomes of Treatment of 32 Cases of Advanced or Relapsed Post-surgery Pulmonary Sarcomatoid Carcinoma

作　　者：熊伟杰[1] 张新星[1] 黄媚娟[1] 陈柳[1] 宋玲玲[1] 薛建新[1] 王永生[1] 卢铀[1] 

机构地区：[1]四川大学华西医院肿瘤中心胸部肿瘤科,成都610041

出　　处：《四川大学学报（医学版）》2014年第2期320-323,共4页Journal of Sichuan University(Medical Sciences)

基　　金："十二.五重大新药创制"科技重大专项--恶性肿瘤新药临床评价研究技术平台(No.2011ZX09302-001)资助

摘　　要：目的探讨Ⅳ期及术后复发肺癌肉瘤患者经三代化疗药物治疗的疗效及影响预后的因素。方法回顾性分析经病理学确诊的32例肺肉瘤样癌患者临床资料,并对其治疗方案及可能影响预后的因素(性别、年龄、肿瘤部位、大小、术后复发或Ⅳ期、病理类型、吸烟状况)进行统计学分析。结果 32例肺肉瘤样癌患者中初诊Ⅳ期10例,复发或转移肺肉瘤样癌患者22例。所有患者均先后接受吉西他滨联合顺铂(GP)或紫杉醇联合顺铂(TP)方案化疗。中位总生存时间(OS)为14个月、中位无进展生存时间(PFS)为5个月,客观缓解率21.9%(7/32)。不同性别、年龄、部位、病理类型、接受TP或GP方案化疗及吸烟史的患者,OS差异均无统计学意义。肿瘤直径在>6cm与≤6cm患者,中位OS分别为16个月、12个月,两组间差异有统计学意义(P<0.05)。术后复发与Ⅳ期在患者中位OS分别为14个月、8个月,两组间差异有统计学意义(P<0.05)。初次诊断为Ⅳ期和肿瘤直径>6cm是独立的不良预后因素。结论在我们的研究中,TP和GP方案化疗对术后复发及Ⅳ期肺肉瘤样癌患者的疗效与其他研究中同期别的非小细胞肺癌近似,初次诊断为Ⅳ期和肿瘤直径>6cm是独立不良预后因素。Objective To determine the efficacy of the third generation chemotherapy agents on relapsed post-surgery and advanced pulmonary sarcomatoid carcinoma （PSC）. Methods We reviewed the medical records of 32 PSC patients. Their treatment modalities and survival rate, as well as risk factors associated with the survival rate including gender, age, location and size of tumor, relapse, initial diagnosis of stage, pathologic subtypes and smoking history were analysed. Results All of the 32 PSC patients received chemotherapy with gemcitabine combined with cisplatin （GP） or paclitaxel combined with cisplatin （TP）. They had a median of 14 months overall survive （OS） and 5 months progress-free survive （PFS）. The remission rate was 21. 9%. An initial stage IV diagnosis and a larger than 6 cm tumor in diameter were independent factors associated with poor prognosis. Conclusion The efficacy of TP and GP chemotherapy on patients with relapsed post-surgery and advanced PSC is comparable with that reported by other researchers. An initial stage IV diagnosis and a larger than 6 cm tumor in diameter are predictors of poor prognosis.

关 键 词：肺肉瘤样癌 晚期 复发 治疗 生存分析 

分 类 号：R734.2[医药卫生—肿瘤]