局限期小细胞肺癌交替与序贯放化疗对照研究  

Comparison of alternating and sequential radio-chemotherapy for limited-stage small cell lung cancer

作　　者：王丽杰[1,2] 张初峰 王鹏[1,2] 管燕[2] 刘秀菊[2] 李艳[2] 郭其森[2] 

机构地区：[1]济南大学.山东省医学科学院医学与生命科学学院,山东济南250000 [2]山东省肿瘤医院内二科,山东济南250117

出　　处：《中华肿瘤防治杂志》2015年第4期289-292,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的 探讨交替或序贯放化疗治疗局限期小细胞肺癌（limited-stage small cell lung cancer,LS-SCLC）中,放疗加入时机对其疗效及安全性的影响.方法 收集2008-01-01-2013-01-01在山东省肿瘤医院行交替或序贯放化疗91例LS-SCLC患者,应用EP方案化疗和交替或序贯常规放疗.EP方案：依托泊苷（Vp-16）100 mg/d,静脉滴入,d1～ds;顺铂（DDP）40 mg/d,静脉滴入,d1～d3;3周为1个周期0交替或序贯常规放疗：2.0 Gy/（次·d）,5 d/周,6周.实施≤3个周期化疗后交替放疗者为早期组42例;实施＞3个周期化疗后行放疗者为晚期组49例.所有患者均完成6个周期EP方案化疗和60 Gy/30次的常规放疗.结果 早期组有效率为85.71％（36/42）,比晚期组的81.63％（40/49）提高了4％,但差异无统计学意义,P＞0.05;中位无进展生存期（progression-free survival,PFS）分别为12和10个月,差异有统计学意义,P＜0,05.2组中住总生存期（overall survival,OS）分别为18和17个月,虽差异无统计学意义,P＞0.05;但观察其曲线图,仍可见延长趋势.2组不良反应主要为可耐受的胃肠道反应和骨髓抑制,且差异无统计学意义,P＞0.05.结论 交替或序贯放化疗治疗LS-SCLC患者,先行≤3个周期化疗后放疗者相对于更多周期化疗后放疗者,有提高有效率和延长OS的趋势,但差异无统计学意义.其在延长患者PFS上差异有统计学意义,且不增加其不良反应.OBJECTIVE To investigate the optimal time of radiotherapy in alternating/sequential radio-chemothera- py for limited-stage small cell lung cancer（LS-SCLC）. METHODS Ninty-one patients with LS-SCLC from Jan. 2008 to Jan. 2013 in Shandong Cancer Hospital were retrospectively analyzed and divided into two groups according to the number of chemotherapy cycles before radiotherapy. If the patient received radiotherapy after 3 cycles or fewer of chemotherapy, he was classified into the early group,if not,he was in the late group. All patients received 6 cycles of standard chemotherapy （EP： Vp-16,100 mg/d, d1- d5, DDP 40 mg/d, d1- d3, q3 w） and conventional radiotherapy （2.0 Gy/f/d, 5 d/w, 6w）. RESULTS The response rates （RR） of the early and late groups were 85.71% and 81.63% ,respectively,with no significant difference （P〉0.05）. On the contrary, the median progression-free survival in the early group was better than that in the late group（12 months vs 10 months） , and the difference was significant （P〈0.05）. The median OS of two groups were 18 months and 17 months, respectively,with no statistical difference （P〉0.05）. There was no significant difference between two groups in the adverse reactions, which gastrointestinal reaction and bone marrow suppression were the most common （P〉0.05）. CONCLUSIONS The radiotherapy after 3 cycles or fewer cycles of chemotherapy could not bring significant benefits for the RR and the OS of the patients with LS-SCLC. But it could significantly prolong their PFS and did not increase the adverse reactions.

关 键 词：癌 小细胞肺 化学治疗 放射治疗 序贯放化疗 

分 类 号：R734.2[医药卫生—肿瘤]