局限期小细胞肺癌化疗和放疗联合化疗的疗效.ppt

局限期小细胞肺癌化疗及放疗联合化疗的疗效 Long-term results of chemotherapy alone or combined with radiation therapy for limited stage small cell lung cancer. HU Yulin, CUI Yali, WANG Mingzhi,CUI Shouren, WANG Ruizhi, GAO Yongjun, Yang Yanfei. Objective To evaluate therapeutic outcome of limited stage small cell lung cancer treated with chemotherapy alone or combined with radiation therapy with different doses. Methods A retrospective analysis was performed in 128 Limited-stage small cell lung cancer patients who were treated with three different ways of therapy, from February 1988 to March 1998 in Heilongjiang Provincial Cancer Hospital. All patients were pathologically proved. 42 patients received chemotherapy alone (C), 48 patients were treated by interdigitating chemoradiotherapy (IDG) and other 38 patients received concurrent chemoradiotherapy (CON). Thoracic radiation, 20 patients received ≤45Gy(≤45Gy group),23 patients were given to ≥60Gy(≥60Gy group), 43 patients were given to 45Gy 60Gy. Results The 3-year survival rates of CON group, IDG group and C group were 23.6% , 20.8% and 4.7% respectively. There was significant difference between CON group, IDG group and C group(x2=6.02，p0.05;x2=5.007,p0.05). There was no significance between the CON group and the IDG group (p0.05). Loco-regional recurrence rate (55%) was more frequent in ≤45GY group compared to ≥60GY group (8.7%). Conclusion The chemotherapy combined radiotherapy may improve the patients’ survival .Dose of thoracic radiation had significant effect on the loco-regional recurrence. 小细胞肺癌（SCLC）占肺癌的20%，发展快恶性程度高。长期以来关于局限期SCLC的治疗原则一直存在着争议。近年来研究结果显示联合放射治疗和化疗成为局限期SCLC的标准治疗方案。 但几种联合治疗方案同步进行、交替进行何为最佳方案，放射治疗的最佳时间、最佳放射治疗剂量尚无一致观点。我们对黑龙江省肿瘤医院1988年2月至1998年3月治疗的局限期SCLC放射治疗和化疗远期疗效资料进行分析。以期对局限期SCLC多模式的治疗方案的选择提供临床经验。 1、材料与方法 1.1 一般临床资料 对1988年2月到1998年3月收治的局限期小细胞肺癌患者128例，进行回顾性分析，男82例，女46例，年龄24岁~74岁，中位年龄48岁，中心型108例，周围型20例。患者于分期前均行胸部正侧位X光片，胸部CT，腹部B超（肝、脾、肾、肾上腺）全身骨E-CT扫描，少数病人行头部CT、MRI检查，所有病例均有病理证实，128例局限期病例按美国退伍军人医院制定的标准评定，以接受治疗开始时为准。 局限期初