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背景与目的:近20年来,局限期小细胞肺癌(limited-stage small cell lung cancer,LS-SCLC)放疗方面的进展推动了其综合治疗模式的改变。本研究旨在分析收治的LS-SCLC的放化综合治疗模式及疗效。方法:回顾性分析本院1997年1月—2006年12月收治的LS-SCLC患者的临床资料,入组标准为病理证实且接受根治性目的放疗的患者,就分期检查、放化疗模式及治疗效果进行总结分析。结果:本研究共入组220例患者。绝大部分患者治疗前接受了骨扫描和脑CT或MRI检查。96%的患者接受了诱导化疗,中位诱导化疗周期数为2。仅5%的患者接受了同步放化疗。三维适形放疗和适形调强放疗的比例为25%,中位放疗剂量为56 Gy(39～70 Gy),超分割放疗(每次1.4 Gy,每日2次)的比例为58%。接受脑部预防性放疗的比例为11%。全组中位生存期为23个月(95%CI:20～25个月),2和5年的生存率分别为46%和22%。结论:本院近10年来收治的LS-SCLC总体治疗效果同文献报道相近,分期检查也相对比较完善,但在治疗模式上,同步放化疗的应用比例较低,放疗早期参与和脑部预防性放疗的应用方面尚存在不足,在以后临床实践中有待提高。
BACKGROUND AND PURPOSE: In the recent 20 years, advances in radiotherapy for limited-stage small cell lung cancer (LS-SCLC) have led to a change in its combination therapy model. The purpose of this study was to analyze the radiotherapy and treatment modalities and efficacy of LS-SCLC. Methods: A retrospective analysis of our hospital from January 1997 - December 2006, clinical data admitted LS-SCLC patients, inclusion criteria for the pathologically confirmed and patients receiving radical radiotherapy purposes, on a phased inspection mode and chemotherapy treatment Effect summary analysis. Results: A total of 220 patients were enrolled in this study. Most patients underwent bone scan and brain CT or MRI before treatment. Ninety-six percent of patients received induction chemotherapy, with a median induction chemotherapy cycle of two. Only 5% of patients received concurrent chemoradiation. The proportion of three-dimensional conformal radiotherapy and conformal IMRT was 25%, the median dose was 56 Gy (39-70 Gy), and the fractional radiotherapy (1.4 Gy twice daily) was 58%. The proportion of patients receiving prophylactic brain radiation was 11%. The median overall survival was 23 months (95% CI: 20-25 months) with 2 and 5-year survival rates of 46% and 22%, respectively. Conclusion: Over the past 10 years, LS-SCLC overall treatment effect admitted to hospital with reported similar, check stages are relatively complete, but in the treatment mode, synchronous applications put lower proportion of chemotherapy, radiation therapy early involvement and preventative brain The application of radiotherapy is still inadequate in clinical practice to be improved.