局限期小细胞肺癌前两周期EP方案化疗有效性与预后  

Effect of clinical efficacy of first two-cycle cisplatin plus etoposide chemotherapy on prognosis in limited-stage small cell lung cancer

作　　者：丁新民[1] 冯华松[2] 伏婷婷[2] 聂舟山[2] 潘磊[1] 王勇 

机构地区：[1]首都医科大学附属北京世纪坛医院老年呼吸科,北京100038 [2]中国人民解放军海军总医院呼吸内科

出　　处：《中国老年学杂志》2016年第8期1880-1882,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81071916)

摘　　要：目的探讨前两周期顺铂加依托泊苷（EP）方案化疗敏感性对局限期小细胞肺癌预后的影响。方法选取2007年1月1日至2013年12月31日在中国人民解放军海军总医院确诊局限期小细胞肺癌初治的住院患者58例,接受常规的两周期EP化疗后联合局部放疗。两周期EP方案化疗结束后评估近期疗效,完全缓解（CR）和部分缓解（PR）患者为化疗有效组,无变化（SD）和疾病进展（PD）患者为化疗无效组,继续2-4周期EP方案化疗并同步放疗。观察毒副作用,评估完成4-6周期EP方案化疗同步放疗结束后4 w内的近期临床有效率（RR）,以疾病无进展生存时间（PFS）为随访终点。结果共有55例患者完成4-6周期EP方案化疗及同步放疗,其中化疗有效组39例,化疗无效组16例,两组性别和年龄分布无统计学差异。化疗有效组的RR为79.5%（31/39）,化疗无效组为37.5%（6/16）,χ^2=5.125,P=0.004,差异有统计学意义。中位PFS：化疗有效组18个月,化疗无效组6.0个月,χ^2=5.212,P=0.022,差异有统计学意义。两组骨髓抑制、放射性食管炎及放射性肺炎等不良反应无统计学差异。结论前2周期EP方案化疗有效的局限期小细胞肺癌患者的预后优于化疗无效患者。Objective To study the effect of sensitivity to two cycles of chemotherapy using cisplatin plus etoposide（ EP） before synchronous radiotherapy on prognosis in limited-stage small cell lung cancer（ LS-SCLC）. Methods After two cycles of EP chemotherapy,the patients who had complete response（ CR） and partial response（ PR） were assigned to group A,the others who had no change（ SD） and progressive disease（ PD） were assigned to group B. All patients were given synchronous thoracic radiotherapy（ TRT）（ 60 Gy administered in30 fractions）,and followed by 2 - 4 cycles of EP chemotherapy. The side effects were recorded when or after chemotherapy with synchronous radiotherapy. The short-term responsiveness and progression-free survival（ PFS） of these patients was assessed by follow-up. Results A total of 55 patients finished 4 - 6 cycles of EP chemotherapy with synchronous radiotherapy. There were 39 patients in group A,and 16 in group B,respectively. Group A comprised 19 male and 20 female cases with a median age of 58. 0 years,and group B comprised 9 male and 7 female cases with a median age of 58. 5 years. No differences were observed in gender and age between two groups. The objective response rate（ CR＋ PR） was79. 5%（ 31 /39） in group A compared to 37. 5%（ 6 /16） in group B（ χ^2= 5. 125,P = 0. 004）. The median PFS of group A was18. 0 months,which was different from that of group B（ 6. 0 months）（ χ^2= 5. 212,P = 0. 022）. The adverse reactions（ such as bone marrow suppression,radioactive esophagitis and radiation pneumonitis） between two groups had no statistical differences. Conclusions The prognosis in LS-SCLC is affected by sensitivity to two cycles of EP chemotherapy before synchronous radiotherapy.

关 键 词：局限期小细胞肺癌 化疗敏感性 

分 类 号：R734.2[医药卫生—肿瘤]