局限期小细胞肺癌放化疗的疗效及预后因素

Curative Effect and Prognosis Factors for Patients with Limitedstage Small Cell Lung Cancer Treated with Chemoradiotherapy

[目的]探讨局限期小细胞肺癌（LS-SCLC）放化疗的疗效及其预后影响因素。[方法]回顾性收集2010年1月至2015年6月我院收治的接受放化疗的LS-SCLC患者142例,观察患者近期疗效及不良反应,Kaplan-Meirer法绘制生存曲线和肿瘤无进展生存曲线,对影响患者预后的相关因素行Log-Rank单因素分析和Cox多因素分析。[结果]全组142例LS-SCLC患者经过放化疗后,54例（38.0%）完全缓解、66例（46.5%）部分缓解、16例（11.3%）病变稳定、6例（4.2%）病变进展。患者主要的不良反应有骨髓抑制（114/142,80.3%）、胃肠道反应（107/142,75.4%）、放射性食管炎（71/142,50.0%）和放射性肺炎（28/142,19.7%）。随访3～80个月,患者1、3、5年的总生存率为87.2%、33.6%和22.3%,中位生存时间为24个月;患者1、3、5年的肿瘤无进展生存率为54.5%、26.9%和12.2%,肿瘤无进展中位生存时间为14个月。多因素分析表明KPS评分〈80分、非同步放化疗为LS-SCLC患者放化疗预后的独立危险因素（P〈0.05）。[结论]LS-SCLC患者放化疗取得较好的疗效,同步放化疗预后优于非同步放化疗,KPS评分〈80分是LS-SCLC的独立危险因素。

[Objective] To assess the curative effect and prognosis factors for patients with limitedstage small cell lung cancer（LS-SCLC） treated with chemoradiotherapy. [Methods] Total 142 patients with LS-SCLC treated with chemoradiotherapy in our institution from Jan 2010 to Jun 2015 were reviewed retrospectively. Short-term curative effect and adverse reactions were observed. The Kaplan-Meirer method was used to evaluate the overall survival（OS） and progression-free survival（PFS）. Clinical factors that may affect prognosis were analyzed by Log-Rank test and Cox regression model. [Results] After chemoradiotherapy,complete remission（CP） was in 54（38.0%） cases,partial remission（PR） in 66（46.5%） cases,stable disease（SD） in 16（11.3%） cases,and disease progress（DP） in 6（4.2%） cases. The main adverse reactions were myelosuppression（114/142,80.3%）,gastrointestinal reaction（107/142,75.4%）,radiation esophagitis（71/142,50.0%） and radiation pneumonitis（28/142,19.7%）. During the 3～80 months follow-up period,the 1-,3-,and 5-years OS rate was 87.2%,33.6%,and 22.3%,respectively,and the median survival time was 24 months.The 1-,3-,and 5-years PFS rate was 54.5%,26.9%,and 12.2%,respectively,and the median progression-free survival time was 14 months. Multivariate analysis showed that KPS score 80 and asynchrony chemoradiotherapy were independent risk factors for prognosis in patients with LSSCLC treated with chemoradiother;and the outcome of concurrent radiochemotherapy was better than that of asynchrony chemoradiotherapy. KPS score〈80 was an independent risk factor for poor prognosis in patients with LS-SCLC. [Conclusion] Curative effect of chemoradiotherapy in patients with LS-SCLC is good. And compare with asynchrony chemoradiotherapy,outcome of concurrent radiochemotherapy is better. The KPS score 〈80 is an independent risk factor for prognosis in patients with LS-SCLC.