Qin Tao, Zhou Ningning, Zeng Yin-Duo, Dinglin Xiaoxiao, Zhao Yuanyuan, Liu Huai, Chen Likun
Department of Medical Oncology, Sun Yat-sen University Cancer Center, The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.
Breast Tumor Center, Sun Yat-sen University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, People's Republic of China.
Onco Targets Ther. 2016 Mar 1;9:1095-103. doi: 10.2147/OTT.S97131. eCollection 2016.
High lactate dehydrogenase (LDH) is associated with a large tumor burden in extensive-disease small-cell lung cancer (ED-SCLC). This study evaluated the benefit of additional thoracic radiotherapy (TRT) in patients with ED-SCLC with elevated LDH.
We analyzed 94 patients with ED-SCLC and evaluated LDH at Sun Yat-sen University Cancer Center during the period between January 2000 and March 2010. Patients were divided into two groups according to whether TRT was received. Survival was evaluated by the Kaplan-Meier method and Cox's regression analysis.
The median age of the 94 patients with ED-SCLC was 58.5 years. The main metastatic sites included the liver, bone, brain, and adrenal glands. The response rate in the TRT group was 46.9%. There were 32 patients (34.04%) receiving TRT and 5.3% receiving prophylactic cranial irradiation. The median survival time reached 10 months (95% confidence interval: 8.22, 11.78 months), and the 1-, 2-, and 5-year survival rates were 43.6%, 11.7%, and 2.1%, respectively. There was a significant difference in the median progression-free survival (PFS) and overall survival (OS) between the TRT group and the no TRT group (PFS: 9.0 months vs 6.0 months, P=0.018; OS: 13.0 months vs 9.0 months, P=0.006).
The use of TRT improves the survival of patients with ED-SCLC. Future studies should use the LDH level for categorizing patients for treatment.
高乳酸脱氢酶（LDH）与广泛期小细胞肺癌（ED-SCLC）的肿瘤负荷大有关。本研究评估了对LDH升高的ED-SCLC患者进行额外胸部放疗（TRT）的益处。
我们分析了94例ED-SCLC患者，并于2000年1月至2010年3月期间在中山大学肿瘤防治中心评估了LDH。根据是否接受TRT将患者分为两组。采用Kaplan-Meier法和Cox回归分析评估生存率。
94例ED-SCLC患者的中位年龄为58.5岁。主要转移部位包括肝脏、骨骼、大脑和肾上腺。TRT组的缓解率为46.9%。有32例患者（34.04%）接受了TRT，5.3%接受了预防性颅脑照射。中位生存时间达到10个月（95%置信区间：8.22，11.78个月），1年、2年和5年生存率分别为43.6%、11.7%和2.1%。TRT组和未接受TRT组之间的中位无进展生存期（PFS）和总生存期（OS）存在显著差异（PFS：9.0个月对6.0个月，P=0.018；OS：13.0个月对9.0个月，P=0.006）。
使用TRT可提高ED-SCLC患者的生存率。未来的研究应使用LDH水平对患者进行治疗分类。
