Liu W-s, Zhao L-j, Wang S, Gong L-l, Liu Z-y, Yuan Z-y, Wang P
Department of Pain Relief and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China.
Department of Radiation Oncology and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China.
Eur J Surg Oncol. 2014 Sep;40(9):1156-62. doi: 10.1016/j.ejso.2014.02.232. Epub 2014 Feb 28.
The purpose of this study is to evaluate the role of postoperative radiotherapy (PORT) in resected small-cell lung cancer (SCLC).
This study retrospectively analyzed 143 patients with completely resected SCLC in our institution between 1996 and 2011. The primary endpoint was overall survival (OS). The log-rank test and Cox regression model were used to evaluate the factors influencing local-regional recurrence (LRR) and OS.
The median OS for the entire population was 34 months, and the 5-year OS rate was 34.6%. In multivariate analysis, age, surgical procedure, pathology stage, adjuvant chemotherapy and distant relapse were significant factors for survival. For the whole population, PORT had no effect on OS, with a median OS of 40 months in the PORT group versus 27 months in the non-PORT group (p = 0.260). However, in patients with N1 disease, the median OS were 40 months in the PORT group versus 14 months in the non-PORT group (p = 0.032). The corresponding OS in N2 patients were 35 months versus 17 months, respectively (p = 0.040). Similarly, PORT significantly reduced the LRR in patients with positive lymph node. For patients with N1 disease, the 3-year LRR rate was 0.0% in the PORT group versus 14.3% in the non-PORT group (p = 0.037). The corresponding LLR rate in N2 patients was 4.2% versus 56.6% (p < 0.001).
PORT significantly reduced LRR and improved OS in patients with regional metastasis SCLC. We suggest supplementing PORT in the multimodality treatment of resected SCLC with lymph node metastasis.
本研究旨在评估术后放疗（PORT）在切除的小细胞肺癌（SCLC）中的作用。
本研究回顾性分析了1996年至2011年间在我院接受完全切除的143例SCLC患者。主要终点为总生存期（OS）。采用对数秩检验和Cox回归模型评估影响局部区域复发（LRR）和OS的因素。
整个人群的中位OS为34个月，5年OS率为34.6%。多因素分析显示，年龄、手术方式、病理分期、辅助化疗和远处复发是生存的重要因素。对于整个人群，PORT对OS无影响，PORT组的中位OS为40个月，非PORT组为27个月（p = 0.260）。然而，在N1期疾病患者中，PORT组的中位OS为40个月，非PORT组为14个月（p = 0.032）。N2期患者相应的OS分别为35个月和17个月（p = 0.040）。同样，PORT显著降低了淋巴结阳性患者的LRR。对于N1期疾病患者，PORT组的3年LRR率为0.0%，非PORT组为14.3%（p = 0.037）。N2期患者相应的LLR率为4.2%和56.6%（p < 0.001）。
PORT显著降低了区域转移SCLC患者的LRR并改善了OS。我们建议在切除的伴有淋巴结转移的SCLC的多模式治疗中补充PORT。
