复发性小细胞肺癌的治疗策略及进展

Treatment strategies and progress of recurrent small cell lung cancer

小细胞肺癌是一种对放、化疗敏感，但易复发的实体性肿瘤。对于身体状况许可的小细胞肺癌复发患者，应接受二线化疗；若一线治疗无效或无疾病进展时间小于3个月，应选择与一线化疗非交叉耐药的二线化疗；若一线治疗有效且无疾病进展时间大于3个月，拓扑替康是首选；若无疾病进展时间超过6个月，则可继续原方案治疗；若出现有症状的脑和骨转移、胸腔内复发和（或）出现大气道阻塞、上腔静脉阻塞综合征的患者，可考虑放疗或放、化疗结合。针对小细胞肺癌的生物靶向治疗有待进一步研究。

Small cell lung cancer （SCLC） is a solid tumor, which is sensitive to radiotherapy and chemotherapy, but easy to relapse. If better physical conditions, the recurrent SCLC patients should receive second line chemotherapy. If the first-line treatment fails or progression free time is less than three months,the patients should Be selected with the second-line chemotherapy which has non-cross-resistance with the first-line chemotherapy. If the first-line treatment is effective and progression-free time is more than three months, topotecan is preferred. If progression-free time is more than six months, the original therapeutic regimen can be continued. If patients have symptomatic metastases in brain or bone, intrathoracic relapse, and （or） main airway obstruction, superior vena cava obstruction syndrome, radiotherapy or chemoradiotherapy can be considered. Biological targeted therapy for SCLC is under further study.