小细胞肺癌的治疗现状与进展

Advances and genetic status in the treatment of small cell lung cancer

小细胞肺癌占肺癌总数的15%～20%,具有增殖快、早期转移等特点。尽管其对放、化疗比较敏感,但中位生存期仍然较短。EP/EC方案依旧是局限期小细胞肺癌的标准一线化疗方案。Irinotecan开始成为广泛期小细胞肺癌的一线用药。早期同步放化疗可提高局限期小细胞肺癌的生存率。根治性手术可延长部分早期小细胞肺癌患者的生存时间。单用imatinib疗效较差,联合其他药物可能会提高疗效。Gefitinib已被证实对小细胞肺癌的治疗无效。Temsirolimus有望成为治疗SCLC新的分子靶向药物。

Small cell lung cancer （SCLC）, characterized by rapid growth and early metastasis, accounts for about 15% -20% of all lung cancer. Although SCLC is an chemosensitive and radiosensitive disease, it remains ultimately fatal for the great majority of patients. The combination of etoposide/cisplatin or etoposide/carboplatin is the first line chemotherapy regimen of limited stage disease （ LD - SCLC ） still while irinotecan becomes the first line drug of extensive stage disease （ SD - SCLC）. Early concomitant and accelerated radiotherapy improves survival in LD -SCLC. Curative pulmonary resection is associated with long - term survival in early stage SCLC in some patients. Imatinib has a negligible effect on SCLC. However, the outcome of combination trial of imatinib with other agents in SCLC will be of considerable interest. It has been proved gefitinib had not brought benefit to the patients with SCLC. Temsirolimus mac be a new molecular targetted agent to treat SCLC.