University of Missouri, School of Medicine Columbia, MO, USA.
Division of Hematology and Medical Oncology, University of Missouri, School of Medicine Columbia, MO, USA.
Thorac Cancer. 2014 Jan;5(1):57-62. doi: 10.1111/1759-7714.12059. Epub 2014 Jan 2.
The purpose of this study is to determine prognostic factors and survival in patients who present with combined small-cell lung cancer (SCLC).
A retrospective review of combined SCLC histology in patients treated between1995-2010 was undertaken. Demographics, diagnostic information, disease characteristics, treatment modality, and survival were captured. Survival estimates were performed using Kaplan Meier analysis. Statistical significance was defined as P < 0.05.
Forty-one patients were identified, and 35 records were available for analysis. Median age at diagnosis was 68 (range 50-85). The study included 20 (57%) women and 15 (43%) men; and 94% had a current or former history of smoking. Histology was SCLC/large cell carcinoma not otherwise specified in 28 (80%), and SCLC/adenocarcinoma or SCLC/squamous cell carcinoma in seven (20%). Cardiac or pulmonary comorbidities were present in 80% of patients, and 24 patients had metastatic disease at presentation. Twenty-eight patients received treatment of chemotherapy (n = 24), cranial radiotherapy (n = 5), or thoracic radiotherapy (n = 7). Staging was as follows: stage I-III (n = 11), stage IV (n = 24). Median survival was 15.4 months (range <1-53 months) and 3.4 months (range <1-21.9 months) for American Joint Committee on Cancer (AJCC) stage I-III and stage IV, respectively. Estimated overall six and 12 month survival was 82%, 55%, 37%, and 17% for stage I-III and stage IV, respectively. An improved overall survival rate was found for patients with an Eastern Cooperative Oncology Group performance status of <2, and no weight loss (P < 0.05).
Akin to SCLC, advanced stage combined SCLC portends a poor prognosis. Perhaps novel chemotherapeutic drugs or targeted agents may improve outcomes for future patient populations.
本研究旨在确定同时患有小细胞肺癌（SCLC）的患者的预后因素和生存情况。
对 1995 年至 2010 年间接受治疗的同时患有 SCLC 组织学的患者进行回顾性分析。收集人口统计学、诊断信息、疾病特征、治疗方式和生存情况。使用 Kaplan-Meier 分析进行生存估计。统计学意义定义为 P<0.05。
共确定 41 例患者，其中 35 例可供分析。诊断时的中位年龄为 68 岁（范围为 50-85 岁）。研究包括 20 名（57%）女性和 15 名（43%）男性；94%有当前或既往吸烟史。组织学上，28 例（80%）为小细胞癌/非特指大细胞癌，7 例（20%）为小细胞癌/腺癌或小细胞癌/鳞状细胞癌。80%的患者存在心脏或肺部合并症，24 例患者在就诊时存在转移性疾病。28 例患者接受了化疗（n=24）、颅放疗（n=5）或胸放疗（n=7）治疗。分期如下：I-III 期（n=11），IV 期（n=24）。根据美国癌症联合委员会（AJCC）分期，I-III 期和 IV 期的中位生存期分别为 15.4 个月（范围为<1-53 个月）和 3.4 个月（范围为<1-21.9 个月）。I-III 期和 IV 期的估计总 6 个月和 12 个月生存率分别为 82%、55%、37%和 17%。ECOG 表现状态<2 和无体重减轻的患者总体生存率提高（P<0.05）。
与 SCLC 类似，晚期合并 SCLC 预示预后不良。也许新的化疗药物或靶向药物可能会改善未来患者群体的预后。
