自体外周血干细胞移植(APBSCT)支持下大剂量化疗治疗小细胞肺癌的长期随访

Long-term consecutive follow-up of high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of small cell lung cancer

目的 探讨自体外周血干细胞移植 (APBSCT)支持下高剂量化疗治疗小细胞肺癌的疗效和长期生存情况。方法 全组 7例病理诊断明确的小细胞肺癌患者 ,6例常规化疗达到CR或PR ,1例为手术切除原发病灶后给予 6周期常规化疗。给予APBSCT支持下高剂量化疗 ,环磷酰胺CTX 6g/m2 ,足叶乙甙1.2 g/m2 ,卡铂 1.2 g/m2 ,其中 6例化疗后进行局部放疗 ,另 1例因年龄超过 60岁且合并肺炎未进行局部放疗。均进行了长期随访 ,中位随访时间 2 7( 2 5～ 82 )个月。结果 所有病例生存均超过 2年 ,其中 3例生存超过 5年 ,1例最长已达 82个月。死亡 3例 ,分别生存 2 6、2 7、2 7个月。结论 APBSCT支持下高剂量化疗辅以局部放疗治疗小细胞肺癌 ,尤其是对年龄相对较轻、一般状况良好、常规化疗达CR的患者 ,有助于延长患者生存 。

Objective To study the efficacy and long term survival of high dose chemotherapy supported by autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of small cell lung cancer (SCLC). Methods Seven patients with pathologically confirmed SCLC were enrolled into the study, including 6 patients who had achieved CR or PR after conventional chemotherapy, and 1 patient who underwent surgical treatment and 6 cycles of conventional postoperative chemotherapy. All patients received a high dose chemotherapy regimen of cyclophosphamide 6 g/m 2, etoposide 1.2 g/m 2, carboplatin 1.2 g/m 2 following APBSCT. Six of 7 patients received local radiotherapy after the procedure, however, another patient over 60 years did not receive local radiotherapy because of pneumonia complication. All patients were consecutively followed up and median follow up duration was 27 (25 82) months. Results Survival of the 7 patients was longer than 2 years. Three patients were still alive for more than 5 years after treatment, and the longest one up to 82 months. Three patients died and their survival time was 26, 27 and 27 months respectively. Conclusion High dose chemotherapy supported by APBSCT combined with local radiotherapy may be helpful to prolong survival and improve prognosis for SCLC, especially to those patients with limited disease, relatively younger age and better performance status, and responding to conventional chemotherapy.