132例小细胞肺癌中西医结合治疗临床总结

Clinical summarization of 132 SCLC cases treated with therapy integrated Chinese and western medicine

目的回顾性总结132例小细胞肺癌中西医结合治疗结果。方法132例均分型口服中药，中医治则主要是祛痰化瘀、祛风通络、散结润肺，同时口服本院院内制剂肺瘤平膏，15g／次，3次／d。中药治疗同时全部病人接受化疗，方案以COA、COME、EP、CAP为主，一般2～3周期后与其他方案交替使用。其中53例配合局部放疗，放射总量：40～70GY。结果随访至2004年12月30日，存活19例，失访20例，死亡93例。生存期自治疗首日至死亡日或失访日止。全组平均、中位生存期分别为20．6月、11月，1、2、3、5年生存率分别为46．97％、18．94％、11．36％和5．30％；中药加放化疗组平均、中位生存期分别为34．9月、16月，1、2、3、5年生存率分别为67．92％、32．07％、22．64％和9．43％；中药加化疗组平均、中位生存期分别为11．6月、8月，1、2、3、5年生存期32．91％、10．13％、3．79％和2．53％。中药加放化疗组和中药加化疗组2、3年生存率相比有极显著性差异，5年生存率有显著性差异。中药加化疗组、中药加放化疗组的5年生存率和中位生存期均高于文献报道。结论中药结合放化疗治疗小细胞肺癌疗效肯定，值得进一步加强研究。

Objective To review the therapeutic outcome of 132 cases of small-cell lung cancer （SCLC） treated with the therapy integrated Chinese and western medicine. Methods All cases were given differentiation and Chinese herbal drugs in the treatment principle of expelling phlegm and resolving stagnation, expelling wind and dredging collaterals, and dispersing accumulation and moistening lung. At the same time all the cases took Feiliuqing Electuary （prepared in this hospital） orally with a dose of 15g once and three times a day, and chemotherapy （ including mainly the plan of COA, COME, EP and CAP alternately, group 1 ）. There were 53 cases （ group 2） were given local radiotherapy with total amount of 40-70 Gy besides the above treatment. Results All the cases were visited until December 30, 2004. There were 19 cases survived, 20 missed and 93 died. The survival time was started from the first day of the treatment and stopped on the day of death or missing. The average and median survival times were 20.6 months and 11 months respectively in all cases. The survival rates in 1^st, 2^nd, 3^rd and 5^th years were 46.97%, 18.94%, 11.36% and 5.30% respectively. In group 2 the average and median survival times were 34.9 months and 16 months and the survival rates in 1^st, 2^nd, 3^rd and 5^th years were 67.92%, 32. 07%, 22.64% and 9.43%. In group 1 the average and median survival times were 11.6 months and 8 months and the survival rates in 1^st, 2^nd, 3^rd and 5^th years were 32.91%, 10. 13%, 3.79% and 2. 53%. The comparison of survival rates of 2^nd and 3^rd years between two groups was much significantly different and that of 5^th year was significantly different. The survival rates of 5^th year in two groups were all higher than that reported in documents. Conclusion The therapy combined Chinese herbal drugs, chemotherapy and radiotherapy had a reliable curative effect on SCLC, which was worth further random control research.