小细胞肺癌伴骨转移化疗后骨硬化与化疗疗效的关系  

The relationship between post-chemotherapy osteosclerotic changes and chemotherapy response in small cell lung cancer (SCLC) with bone metastases:a preliminary study

作　　者：赖海辉 雷强[1] 万齐[1] 邹乔[1] 包盈莹[1] 李新春 LAI Hai-hui;LEI Qiang;WAN Qi(Department of Radiology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院放射科,广州510120 [2]惠州市第一人民医院放射科,惠州516001

出　　处：《放射学实践》2019年第9期1019-1023,共5页Radiologic Practice

基　　金：国家自然基金青年项目(81601457);广东省医学科研基金项目(A2016410)

摘　　要：目的:探讨小细胞肺癌(SCLC)骨转移患者化疗后骨硬化改变与化疗疗效的关系。方法:搜集32例经病理活检证实的SCLC并随访证实存在骨转移患者化疗前后的CT资料,32例患者均为首次接受铂类联合化疗,将肺癌患者分为化疗有效组(完全缓解+部分缓解)和化疗无效组(稳定+进展)。结合化疗前后的CT资料将化疗后SCLC骨转移患者分为骨硬化组和无骨硬化组,分析骨硬化改变与SCLC化疗疗效的关系。结果:32例SCLC患者经过两个化疗周期后,26例化疗有效(有效组),6例化疗无效(无效组);22例出现骨质硬化(硬化组),10例未出现骨质硬化(无硬化组)。22例骨硬化患者中21例(21/22)化疗有效,1例化疗无效;而10例无骨硬化患者中化疗无效和有效者各5例。两个化疗周期后骨转移瘤骨硬化组的化疗有效率(95.5%)明显高于无硬化组(50%),差异有统计学意义(P=0.006)。结论:SCLC骨转移瘤患者化疗后的骨硬化改变有可能作为评估化疗疗效的一个影像指标,具有一定的临床辅助诊断价值。Objectives: To explore the relationship between osteosclerotic changes and chemotherapy response in SCLC patients with bone metastases. Methods: Thirty-two SCLC patients confirmed by pathological and bone metastasis confirmed by clinical follow-up were enrolled.All patients were received platinum combination chemotherapy for the first time.According to RECITST1.1,lung cancer was divided into effective group (CR+PR) and ineffective group (PD+SD).All bone metastases were divided into osteosclerosis group and non-osteosclerosis group according to their CT imaging features of pro- and post-chemotherapy.The relationship between osteosclerotic changes and SCLC chemotherapy response in bone metastases was analyzed by chi-square test. Results: After two chemotherapy cycles of 32 SCLC patients,chemotherapy was effective in 26 cases (effective group) and ineffective in 6 cases (invalid group).There were 22 cases in osteosclerosis group and 10 cases in the non-osteosclerosis group.In 22 cases of osteosclerosis group,21 cases were in effective group,only 1 case was ineffective,and 10 patients of non-osteosclerosis group was equally split between invalid and effective group.The incidence of osteosclerosis in bone metastases after all two cycles of effective chemotherapy was significantly higher than that of the ineffective chemotherapy group ( P <0.01). Conclusion: The osteosclerotic change of bone metastases may be regarded as an imaging index to evaluate the effect of SCLC chemotherapy,which is of importance in clinical practice.

关 键 词：小细胞肺癌 肺肿瘤 骨硬化 骨转移 体层摄影术 X线计算机 化疗 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]