放疗联合化疗治疗局限期小细胞肺癌的疗效及预后影响因素分析  

Efficacy and prognostic factors of radiotherapy combined with chemotherapy in patients with LSCLC

作　　者：刘珍[1] 解翠林[2] 朱琳燕[2] 

机构地区：[1]湖北省荆州市第一人民医院肿瘤科,荆州434000 [2]鄂东医疗集团黄石市中心医院肿瘤科,黄石435000

出　　处：《中国肿瘤临床与康复》2016年第9期1036-1039,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：湖北省自然科学基金计划项目(81071826)

摘　　要：目的探讨放疗联合化疗治疗局限期小细胞肺癌（LSCLC）的疗效及预后因素。方法回顾性分析荆州市第一人民医院2010年1月至2015年1月间收治且资料完整的238例LSCLC患者的临床资料,所有患者均采用放疗联合化疗的方法进行治疗。检测并记录患者在进行放化疗综合治疗中的不良反应,并对所有患者的临床特征及疗效进行相关性分析,对影响患者预后相关因素单、多因素进行分析,并对其结果进行比较。结果所有患者中位生存时间为23.4个月,1、2、3年的生存率分别为66.5%、31.2%、15.3%。主要的不良反应为胃肠道反应、骨髓抑制、放射性食管炎和放射性肺炎等,而≥3级骨髓抑制的发生率为34.7%,≥3级胃肠道反应的发生率为19.4%,有临床症状的放射性肺炎发生率为9.7%,≥2级放射性食管炎的发生率为33.8%。患者的年龄、是否吸烟、PS评分与疗效有关,差异有统计学意义（P〈0.05）,而性别、家族史等与疗效无关,差异无统计学意义（P〉0.05）。影响患者预后的因素为年龄、性别、吸烟、家族史、功能状态评分（PS）等,〈60岁、不吸烟、PS评分在0~1分的患者的中位生存时间均明显长于≥60岁、吸烟、PS评分≥2分的患者,差异有统计学意义（P〈0.05）,即患者的年龄、是否吸烟和PS评分均是患者预后的影响因素。PS评分和是否吸烟为影响患者预后的独立的因素。结论放疗联合化疗治疗LSCLC可获得较好的疗效,效果显著。PS评分和是否吸烟为影响LSCLC预后的独立因素。Objective To study the effectiveness and prognostic factors of radiotherapy combined with chemotherapy in patients with limited stage small cell lung cancer（ LSCLC）. Methods Two hundred and thirty-eight LSCLC patients treated in Huangshi Central Hospital from January 2010 to January 2015 were selected as the subjects. All patients were treated with radiotherapy combined with chemotherapy. Side effects in all patients in the process of treatment were detected and recorded. The clinical characteristics and therapeutic effect of all patients were analyzed. Prognosis related factors were examined by single factor and multi factors analysis. Results The median survival time was 23. 4 months. Survival rates at 1,2 and 3years were 66. 5%,31. 2% and 15. 3% respectively. The primary side effects were gastrointestinal reactions,bone marrow suppression,radiation induced esophagitis and pneumonia,etc. Incidence of myelosuppression（ ≥3） was 34. 7%. Gastrointestinal reaction rate（ ≥3） was 19. 4%. Incidence of radiation pulmonary inflammation with clinical symptoms was 9. 7%. Radiation induced esophagitis（ ≥2） occurred in33. 8% of patients. Therapeutic efficacy was associated with age,smoking and PS score（ P〈0. 05） but not with gender and family history（ P〉0. 05）. Thus,factors influencing prognosis possibly were age,gender,smoking,family history and PS score. Median survival of patients less than 60 years,non-smoking and PS score among 0 ~ 1 was significantly longer than that of patients greater than or equal to 60 years,smoking and PS score greater than or equal to 2. The difference is statistically significant（ P〈0. 05）. Namely,age,smoking status and PS score are factors influencing the prognosis of the patients. PS score and smoking status are independent factor influencing the prognosis of patients. Conclusion Radiotherapy combined with chemotherapy for LSCLC has remarkable efficacy and PS score and smoking status are independent factors influencing prognosis of LSCLC.

关 键 词：癌 小细胞肺 放射疗法 药物疗法 治疗结果 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]