术后小细胞肺癌患者预防性脑照射研究进展

Research progress on prophylactic cranial irradiation in patients with surgically resected small cell lung cancer

小细胞肺癌（SCLC）发病数较少,约占所有支气管肺癌的13%~20%,恶性程度较高,短时间内易复发转移。确诊时局限期小细胞肺癌约占SCLC的30%,符合手术患者仅占5%。放化疗后完全缓解者仍有一半以上患者发生脑转移。术后Ⅰ、Ⅱ、Ⅲ期SCLC患者脑转移发生率为6%~14%、13%~38%、11%~36%。预防性脑照射（PCI）可提高放化疗后完全缓解者总生存率,并降低脑转移发生率,是局限期SCLC综合治疗的重要组成部分。但是,PCI的临床应用仍存一些争议,手术完全切除的SCLC患者行PCI的疗效不一。本文对此问题进行文献综述,并介绍该领域的研究进展。

The incidence of small cell lung cancer （SCLC） is relatively low, which approximately accounts for 13%-20% of all types of lung cancers. SCLC is characterized by high-degree malignancy and high metastasis and recurrence rates within a short period of time. Upon the confirmed diagnosis, limited-stage SCLC approximately accounted for 30% of SCLC and merely 5% of these patients were eligible for surgery. Over half of the patients who obtained complete remission after chemoradiotherapy presented with brain metastases. The postoperative incidence of brain metastases in patients with stage Ⅰ, Ⅱ and Ⅲ SCLC was 6%-14%,13%-38% and 11%-36%, respectively. Prophylactic cranial irradiation （PCI） can enhance the overall survival rate of patients with complete remission after chemoradiotherapy and reduce the incidence of brain metastasis, which is a pivotal part of comprehensive treatment of limited-stage SCLC. However, the application of PCI remains controversial in clinical practice and the clinical efficacy for patients with surgically resected SCLC significantly varies. In this article, literature review was conducted and the research progress in this field was summarized.