外科治疗Ⅲa期小细胞肺癌的疗效分析  

Analysis of Efficacy of Surgical Treatment for Ⅲa Small Cell Lung Cancer

作　　者：窦学军[1] 王志远[1] 王亮[1] 路伟强 马云雷[1] 许绍发 

机构地区：[1]航天中心医院,北京100049 [2]北京市胸科医院胸心外科,北京101149

出　　处：《中国肺癌杂志》2017年第2期88-92,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的小细胞肺癌(small cell lung cancer,SCLC)占所有肺癌的比例近15%左右。SCLC作为一种高度侵袭性肿瘤,恶性程度高,转移早而广泛,对化疗、放疗敏感,初治缓解率高,但容易复发,如果未经任何治疗,其中位生存期仅为4个月-6个月。近年来对SCLC开展了许多研究,但仍未改变SCLC的临床治疗策略,治疗上仍局限于诸如足叶乙甙+顺铂(EP)或卡铂(CE)化疗方案等一些经典的治疗手段,对手术治疗在SCLC治疗,尤其是Ⅲa期的治疗仍未达成共识。本研究旨在探讨Ⅲa期SCLC的外科手术为主的综合治疗对SCLC的临床治疗效果及对影响预后的因素。方法通过回顾性分析1995年1月-2010年12月首都医科大学附属北京胸科医院收治手术治疗的78例SCLC患者的临床资料。对患者进行随访,全组病例对性别、年龄、肿瘤大小、淋巴结转移状况、肿瘤-淋巴结-转移(tumor-node-metastasis,TNM)分期、手术方式及术后辅助放化疗进行统计学分析其手术治疗与预后的关系。结果本组78例患者中位生存期为13.93个月,术前新辅助化疗47例,中位生存期为14.25个月;术后辅助化疗31例,中位生存期为13.83个月;两者无统计学差异。单站单个(微转移)淋巴结转移28例中位生存期为17.1个月,多站多个淋巴结转移(广泛转移)50例,中位生存期为11.9个月。两者有明显统计学差异(P<0.01)。结论进一步评价外科治疗在SCLC综合治疗中的地位及价值,对于Ⅲa期SCLC,以手术为主的综合治疗可以使部分患者受益。Background and objective Small cell lung cancer（SCLC） accounts for nearly 15% of all cases of cancer. As a type of highly invasive tumors, SCLC has high degree of malignancy, early and extensive metastasis, and is sensitive to chemotherapy and radiotherapy. The early treatment response rate of SCLC is high but it can also relapse rapidly without any treatment. Its median survival time is merely four to six months. Although many studies on SCLC have been conducted in recent years, its clinical treatment strategies have remained unchanged. The treatment of SCLC is still confined to chemotherapy regimens of etoposide plus cisplatin（EP） and other classic treatments because the surgical treatment of SCLC, particularly for IIIa treatment, has yet to reach a consensus. This study investigated the prognostic factors and clinical therapy effect in the comprehensive treatment of IIIa SCLC after surgical treatment. Methods This study was conducted through the retrospective analysis of the clinical data of 78 patients with SCLC who underwent surgical treatment in Beijing Chest Hospital affiliated to Capital Medical University between January 1995 and December 1995. Through follow-up, we performed statistical analysis of each patient＇s gender, age, tumor size, lymph node metastasis, tumor-node-metastasis（TNM） staging, surgical methods, and adjuvant radiation and chemotherapy. Results The median survival in this clinical trial team was 13.93 months. Among the participants, 47 patients accepted neoadjuvant chemotherapy and their median survival were 14.25 months. By contrast, 31 patients accepted postoperative adjuvant chemotherapy and their median survival were 13.83 months. No statistical difference was observed between the two groups. Moreover, 28 patients were of single Lymph node metastasis and their median survival was 17.1 months. By contrast, 50 patients were of multiple lymph node metastasis and their median survival was 11.9 months. Significant statistical difference was observed between the two groups�

关 键 词：肺肿瘤 手术治疗 综合治疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]