联合放化治疗合并同侧胸腔积液局限期小细胞肺癌效果观察  

Clinical Observation of Chemoradiotherapy in the Treatment of Limited Stage Small Cell Lung Cancer with Ipsilateral Pleural Effusion

作　　者：陈连刚[1,2] 刘建坤[2] 胡兴茂[2] 张怡梅[2] 赵青兰[2] 朱铁年[1,2] 

机构地区：[1]河北医科大学研究生学院,石家庄050017 [2]解放军白求恩国际和平医院肿瘤科,石家庄050082

出　　处：《临床误诊误治》2016年第2期88-91,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题计划(20130014)

摘　　要：目的观察联合放化治疗合并同侧胸腔积液局限期小细胞肺癌（LSCLC）效果。方法 2008年1月—2012年1月解放军白求恩国际和平医院肿瘤科收治符合纳入标准并经病理和影像学检查证实为合并同侧胸腔积液LSCLC 58例,均先行2-4个周期诱导化疗,据诱导化疗后胸腔积液吸收及后续治疗情况将其分为A、B、C 3组,诱导化疗后胸腔积液消失行胸部放疗后继续巩固化疗者为A组（22例）,诱导化疗后胸腔积液消失后继续原方案化疗者为B组（17例）,胸腔积液未消失或增加或疗效评价为进展继续进行化疗者为C组（19例）。所有患者均行近、远期疗效及不良反应评价,观察比较3组近、远期疗效及不良反应情况。结果 58例诱导化疗后有效率为77.6%,中位生存期18个月,1、2、3年生存率70.0%、31.3%和17.3%,39例诱导化疗后胸腔积液消失。A、B、C 3组治疗结束后有效率分别为81.8%、76.5%和73.7%,中位生存期分别为21.2、16.4和14.1个月,1年生存率分别为81.8%、64.7%和57.9%,2年生存率分别为45.5%、24.8%和18.9%,3年生存率分别为26.5%、16.5%和6.3%。3组间中位生存期、1年生存率及3年生存率比较差异有统计学意义（P〈0.05）,其中A组长于或高于B组和C组,差异均有统计学意义（P〈0.05）。A、B、C 3组不良反应发生率比较差异均无统计学意义（P〉0.05）。结论联合放化治疗合并同侧胸腔积液LSCLC可延长生存期。Objective To retrospectively analyze the effect and outcome of chemoradiotherapy in the treatment of limited stage small cell lung cancer（ LSCLC） with ipsilateral pleural effusion. Methods After being confirmed by pathology and imaging diagnosis,58 LSCLC patients with ipsilateral pleural effusion in the department of medical oncology of Bethune International Peace Hospital of PLA during January 2008 and January 2012 underwent 2 - 4 cycles of induction chemotherapy. After that,according to the treatment situation of pleural effusion,22 patients（ Group A） with pleural effusion disappearing after induction chemotherapy underwent chest radiotherapy,17 patients（ Group B） with pleural effusion disappearing underwent same chemotherapy regiment,19 patients（ Group C） without disappearance or increasing of pleural effusion or clinical efficacy evaluation of progress were given chemotherapy regiment. All the patients were evaluated for curative effect and adverse reaction and the effects of the 3 groups were observed. Results The response rate of all patients was 77. 6% after induction chemotherapy and 39 patients achieved disappearance of pleural effusion. The median survival time was 18 months,and the 1,2 and 3-year survival rates were 70. 0%,31. 3% and 17. 3% respectively. The response rates of group A,B and C were81. 8%,76. 5% and 73. 7% respectively,and the median survival time were 21. 2,16. 4 and 14. 1 months respectively. 1-year survival rates were 81. 8%,64. 7% and 57. 9% respectively,2-year survival rates were 45. 5%,24. 8% and 18. 9% respectively,3-year survival rates were 26. 5%,16. 5% and 6. 3% respectively. There was statistical significance of the median survival time,1-year survival rate and 3-year survival rate among the 3 groups（ P〈0. 05）,the median survival time and survival rate of group A was longer or higher than that of group B and group C,with statistically significant difference（ P〈0. 05）. There was no statistical significance of the adverse reaction rates among 3 groups�

关 键 词：小细胞肺癌 胸腔积液 化学治疗 放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]