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早期放化疗对局限期小细胞肺癌患者的疗效

Effect of early chemoradiotherapy in patients with limited stage small cell lung cancer.

作者信息

Ha In-Bong, Jeong Bae-Kwon, Jeong Hojin, Choi Hoon-Sik, Chai Gyu-Young, Kang Myoung-Hee, Kim Hoon Gu, Lee Gyeong-Won, Na Jae-Beom, Kang Ki-Mun

机构信息

Department of Radiation Oncology, Gyeongsang National University School of Medicine, Jinju, Korea.

Department of Radiation Oncology, Gyeongsang National University School of Medicine, Jinju, Korea. ; Institute of Health Science, Gyeongsang National University, Jinju, Korea.

出版信息

Radiat Oncol J. 2013 Dec;31(4):185-90. doi: 10.3857/roj.2013.31.4.185. Epub 2013 Dec 31.

Abstract

PURPOSE

We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC).

MATERIALS AND METHODS

Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks.

RESULTS

The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively.

CONCLUSION

We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.

摘要

目的

我们评估了早期放化疗对局限期小细胞肺癌(LS-SCLC)患者治疗的效果。

材料与方法

回顾性分析了2006年1月至2011年12月间31例经组织学证实的LS-SCLC患者,这些患者接受了两个周期的化疗,随后进行同步放化疗和巩固化疗。化疗方案由依托泊苷和顺铂组成。胸部放疗剂量为50至60 Gy(中位剂量54 Gy),在5至6.5周内给予。

结果

随访期为5至53个月(中位22个月)。放化疗后,35.5%的患者(11例)显示完全缓解,61.3%(19例)显示部分缓解,3.2%(1例)显示疾病进展,总缓解率为96.8%(30例)。1年、2年和3年总生存率(OS)分别为66.5%、41.0%和28.1%,中位OS为21.3个月。1年、2年和3年无进展生存率(PFS)分别为49.8%、22.8%和13.7%,中位PFS为12个月。失败模式为:局部区域复发29.0%(9例),远处转移9.7%(3例),局部区域和远处转移均为9.7%(3例)。白细胞减少、贫血和血小板减少的3级或4级毒性分别在32.2%、29.0%和25.8%的患者中观察到。3级放射性食管炎和放射性肺炎分别为12.9%和6.4%。

结论

我们得出结论,LS-SCLC的早期放化疗提供了可行且可接受的局部控制和安全性。

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