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目的研究局部放射治疗(简称放疗)联合化学治疗(简称化疗)影响小细胞肺癌(SCLC)疗效的主要因素。方法选择172例局限期SCLC患者,其中男性140例,女性32例;年龄29~72岁,中位年龄46岁。年龄大于60岁者56例,小于60岁者116例。应用局部放疗联合化疗综合治疗模式,观察治疗效果。对其相关临床特征进行χ2检验。结果患者1、2、3年生存率分别为82.48%、44.92%、29.76%,中位生存时间为23个月。全组患者完全缓解17例(10%),部分缓解21例(70%),稳定24例(14%),进展10例(6%)。总有效率为80%。疗效与患者一般状况如年龄、性别、吸烟状态、KPS评分等未见明显的相关性,与放化疗模式及初治时实验室指标如血红蛋白、乳酸脱氢酶、肿瘤标志物如神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)等未见明显的相关性。不同疗效者的一线化疗周期数差异具有显著统计学意义(P<0.000 1)。62例(36%)发生Ⅲ~Ⅳ度白细胞减少。结论局部放疗联合化疗治疗局限期SCLC总有效率高,全组患者总体治疗有效率高,毒副反应可耐受,生存情况良好。
Objective To study the main factors influencing the curative effect of small cell lung cancer (SCLC) treated with local radiotherapy (referred to as radiotherapy) combined with chemotherapy (referred to as chemotherapy). Methods 172 patients with localized SCLC were selected, including 140 males and 32 females, aged 29-72 years with a median age of 46 years. 56 cases were older than 60 years and 116 cases were less than 60 years old. The application of local radiotherapy combined with chemotherapy comprehensive treatment model to observe the therapeutic effect. The relevant clinical features of χ2 test. Results The 1, 2, 3-year survival rate of patients was 82.48%, 44.92% and 29.76%, respectively. The median survival time was 23 months. In the whole group, 17 patients (10%) were relieved completely, 21 patients (70%) partially relieved, 24 patients (14%) stabilized, and 10 patients (6%) achieved complete progress. The total effective rate is 80%. Efficacy and general status of patients such as age, gender, smoking status, KPS score no significant correlation with radiotherapy and chemotherapy model and initial laboratory indicators such as hemoglobin, lactate dehydrogenase, tumor markers such as neuron-specific Enolase (NSE), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and so no significant correlation. The number of first-line cycles of chemotherapy with different efficacy was significantly different (P <0.000 1). 62 (36%) Ⅲ ~ Ⅳ grade leukopenia occurs. Conclusion The combination of local radiotherapy and chemotherapy in the treatment of SCLC has a high total effective rate. The overall treatment efficiency of the whole group is high, and the side effects of toxic and side effects are tolerable and the survival is good.