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目的探讨放疗联合化疗治疗局限期小细胞肺癌(LSCLC)的疗效及预后因素。方法回顾性分析荆州市第一人民医院2010年1月至2015年1月间收治且资料完整的238例LSCLC患者的临床资料,所有患者均采用放疗联合化疗的方法进行治疗。检测并记录患者在进行放化疗综合治疗中的不良反应,并对所有患者的临床特征及疗效进行相关性分析,对影响患者预后相关因素单、多因素进行分析,并对其结果进行比较。结果所有患者中位生存时间为23.4个月,1、2、3年的生存率分别为66.5%、31.2%、15.3%。主要的不良反应为胃肠道反应、骨髓抑制、放射性食管炎和放射性肺炎等,而≥3级骨髓抑制的发生率为34.7%,≥3级胃肠道反应的发生率为19.4%,有临床症状的放射性肺炎发生率为9.7%,≥2级放射性食管炎的发生率为33.8%。患者的年龄、是否吸烟、PS评分与疗效有关,差异有统计学意义(P<0.05),而性别、家族史等与疗效无关,差异无统计学意义(P>0.05)。影响患者预后的因素为年龄、性别、吸烟、家族史、功能状态评分(PS)等,<60岁、不吸烟、PS评分在0~1分的患者的中位生存时间均明显长于≥60岁、吸烟、PS评分≥2分的患者,差异有统计学意义(P<0.05),即患者的年龄、是否吸烟和PS评分均是患者预后的影响因素。PS评分和是否吸烟为影响患者预后的独立的因素。结论放疗联合化疗治疗LSCLC可获得较好的疗效,效果显著。PS评分和是否吸烟为影响LSCLC预后的独立因素。
Objective To investigate the efficacy and prognosis of radiotherapy combined with chemotherapy in the treatment of small cell lung cancer (LSCLC). Methods The clinical data of 238 patients with LSCLC who were admitted to the First People’s Hospital of Jingzhou from January 2010 to January 2015 were retrospectively analyzed. All the patients were treated with radiotherapy combined with chemotherapy. Detect and record the patients’ adverse reactions in the comprehensive treatment of radiotherapy and chemotherapy, and analyze the correlation between the clinical features and curative effect of all the patients, analyze the single and multiple factors that affect the prognosis of patients, and compare the results. Results The median survival time of all patients was 23.4 months. The survival rates at 1, 2 and 3 years were 66.5%, 31.2% and 15.3%, respectively. The main adverse reactions were gastrointestinal reactions, myelosuppression, radiation esophagitis and radiation pneumonitis, while the incidence of grade 3 myelosuppression was 34.7% and the incidence of grade 3 gastrointestinal reactions was 19.4% The incidence of symptoms of radiation pneumonitis was 9.7%, the incidence of ≥2 esophageal radiation was 33.8%. Patient’s age, whether smoking, PS score and curative effect, the difference was statistically significant (P <0.05), while sex, family history and other curative effect has no statistical significance (P> 0.05). The factors affecting the prognosis of patients were age, gender, smoking, family history, PS, etc. The median survival time of patients <60 years old and non-smoking patients with PS score of 0 to 1 was significantly longer than that of ≥60 years , Smoking, and PS score≥2, the difference was statistically significant (P <0.05), that is, the patient’s age, smoking and PS scores were the prognostic factors of patients. PS score and whether smoking is an independent factor affecting the prognosis of patients. Conclusion Radiotherapy combined with chemotherapy in the treatment of LSCLC can obtain better curative effect, the effect is remarkable. PS score and whether smoking is an independent factor affecting the prognosis of LSCLC.