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[加齐大学放射肿瘤学系治疗的小细胞肺癌患者的回顾性分析]

[Retrospective analysis of patients with small cell lung cancer treated at Gazi University Department of Radiation Oncology].

作者信息

Erpolat O Petek, Göksel Fatih, Bora Hüseyin, Akmansu Müge, Unsal Diclehan, Oztürk Can, Egehan Ibrahim, Aşikoğlu Haluk

机构信息

Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.

出版信息

Tuberk Toraks. 2005;53(2):139-47.

Abstract

The combination of radiotherapy (RT) and chemotherapy (CT) is the main treatment modality of limited-stage small cell lung cancer (SCLC). The application of radiation timing, doses, fraction schedules in this modality and the indication of prophylactic cranial irradiation is recently controversial. In this retrospective study, these subjects were evaluated by considering our patients results. Seventy patients having adequate data for examination with limited-stage SCLC were referred to our clinic in the period between December 1995 and December 2002. The patients were classified according to their response to CT, the dose and timing of RT applications. The effects of obtained variables on overall survival were analyzed. Male/ female ratio was 5/1; and the mean age was 55 years (range 31-80 years). The mean follow-up of all patients was 10 months and the mean survival time was 16 months. An objective (complete and partial) response to CT administered before RT was seen in 47 (67%) patients. The survival time was better in the CT responding patients (median 11 months versus 6 months, p= 0.002). The application of more than 50 Gy radiation dose was found to be ineffective on survival. An improvement in survival was observed in RT application beginning before fourth cycle CT (median 14 months versus 8 months p= 0.01). In despite of the ineffectiveness of prophylactic cranial irradiation on survival is observed in survival analysis, it was found to be a parameter affecting survival in Cox-regression analysis. However the most frequently complication during RT was oesophagitis. Grade III was seen in 1 (3%) patient. The response to CT can be accepted as an indicator for survival. We concluded that the administering of RT in the beginning of CT, not administering radiation doses of more than 50 Gy and the necessity of applying prophylactic cranial irradiation to all patients showing complete response are points to be considered according to our retrospective analysis.

摘要

放疗(RT)与化疗(CT)联合是局限期小细胞肺癌(SCLC)的主要治疗方式。这种治疗方式中放疗的时机、剂量、分割方案以及预防性颅脑照射的指征目前存在争议。在这项回顾性研究中,通过考量我们患者的结果对这些问题进行了评估。1995年12月至2002年12月期间,70例有足够数据用于检查的局限期SCLC患者被转诊至我们的诊所。患者根据其对CT的反应、放疗应用的剂量和时机进行分类。分析所获变量对总生存的影响。男女比例为5∶1;平均年龄为55岁(范围31 - 80岁)。所有患者的平均随访时间为10个月,平均生存时间为16个月。47例(67%)患者在放疗前接受的CT治疗有客观(完全和部分)反应。CT有反应的患者生存时间更长(中位数11个月对6个月,p = 0.002)。发现超过50 Gy的放疗剂量对生存无效。在第4周期CT之前开始放疗可观察到生存改善(中位数14个月对8个月,p = 0.01)。尽管在生存分析中观察到预防性颅脑照射对生存无效,但在Cox回归分析中发现它是影响生存的一个参数。然而,放疗期间最常见的并发症是食管炎。1例(3%)患者出现3级食管炎。对CT的反应可被视为生存的一个指标。根据我们的回顾性分析,我们得出结论,在CT开始时进行放疗、不给予超过50 Gy的放疗剂量以及对所有显示完全反应的患者应用预防性颅脑照射的必要性是需要考虑的要点。

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