放疗联合化疗治疗局限期小细胞肺癌的临床疗效及预后影响因素研究  

Clinical efficacy and prognostic factors of radiotherapy combined with chemotherapy for localized small cell lung cancer

作　　者：苏云涛[1] 朱勇[1] 胡志纲 任建[1] 何荣华 田宁强 SU Yun-tao;ZHU Yong;HU Zhi-gang;REN Jian;HE Rong-hua;TIAN Ning-qiang(Department of Radiotherapy,Baoji Central Hospital,Baoji 721008,Shaanxi,CHINA;Department of Medical Imaging,Baoji Central Hospital,Baoji 721008,Shaanxi,CHINA;Department of Comprehensive Internal Medicine,Baoji Central Hospital,Baoji 721008,Shaanxi,CHINA)

机构地区：[1]宝鸡市中心医院放射治疗科,陕西宝鸡721008 [2]宝鸡市中心医院医学影像科,陕西宝鸡721008 [3]宝鸡市中心医院综合内科,陕西宝鸡721008

出　　处：《海南医学》2019年第11期1385-1387,共3页Hainan Medical Journal

摘　　要：目的观察放疗联合化疗治疗局限期小细胞肺癌(LSCLC)的临床疗效,并探讨其预后的影响因素。方法选择宝鸡市中心医院放射治疗科2012年2月至2015年3月收治的LSCLC患者226例,给予放疗联合化疗治疗,观察患者疗效及治疗过程中发生的不良反应,分析其与临床特征的相关性,同时分析影响预后的相关因素。结果 226例患者经治疗后完全缓解131例,部分缓解63例,无变化27例,疾病进展5例,有效率为85.8%(194/226);患者中位生存时间23.2个月,1年生存率为66.4%(150/226),2年生存率为31.0%(70/226),3年生存率为15.0%(34/226);患者主要不良反应为骨髓抑制、放射性食管炎、放射性肺炎、胃肠道反应,其中≥3级的骨髓抑制发生率为44.6%,≥3级胃肠道反应发生率为28.3%,≥2级的放射性食管炎发生率为35.8%,有临床症状的放射性肺炎发生率为11.5%;单因素分析发现,年龄、是否吸烟、PS评分、肿瘤体积均为患者预后的相关因素(P<0.05);Logistic回归分析发现,年龄、是否吸烟、PS评分、肿瘤体积是影响患者预后的独立影响因素(P<0.05)。结论 LSCLC采用放疗联合化疗治疗可获得较好疗效,患者年龄、是否吸烟、PS评分值,肿瘤体积大小是影响预后的主要因素。Objective To discuss the clinical effects and the prognosis-influencing factors of radiotherapy combined with chemotherapy for localized small cell lung cancer(LSCLC). Methods From February 2012 to March2015, 226 patients with LSCLC in Department of Radiotherapy, Baoji Central Hospital were treated with radiotherapy combined with chemotherapy. The clinical effects, side effects were observed, and the clinical characteristics of the patients were analyzed. The prognostic factors were analyzed by single and multiple factors, and the results were compared. Results Among the 226 patients, there were 131 patients of complete remission, 63 patients of partial remission, 27 patients of no change, 5 patients of disease progression, with the effective rate of 85.8%(194/226). The median survival time of patients was 23.2 months. The 1-year survival rate was 66.4%(150/226), 2-year survival rate was31.0%(70/226), and the 3-year survival rate was 15.0%(34/226). The main adverse reactions were myelosuppression,radiation esophagitis, radiation pneumonia, and gastrointestinal tract reactions. The incidence of myelosuppression(≥grade 3), gastrointestinal reaction(≥grade 3), radiation esophagitis(≥grade 2), and radiation pneumonia with clinical symptoms were 44.6%, 28.3%, 35.8%, 11.5%, respectively. Univariate analysis showed that age, smoking or not,PS score, and tumor volume were all related factors of prognosis(P<0.05). Logistic regression analysis showed that age, smoking or not, PS score, and tumor volume were independent factors influencing prognosis of patients(P<0.05). Conclusion LSCLC can get ideal curative effect by radiotherapy combined with chemotherapy. Age, smoking or not, PS score, and tumor size are the main factors affecting the prognosis of LSCLC.

关 键 词：局限期小细胞肺癌 放疗 化疗 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]