晚期原发性肺淋巴上皮瘤样癌：临床表现、治疗及预后
Advanced primary pulmonary lymphoepithelioma-like carcinoma: clinical manifestations, treatment, and outcome.
作者信息
Lin Chun-Yu, Chen Ying-Jen, Hsieh Meng-Heng, Wang Chih-Wei, Fang Yueh-Fu
机构信息
Department of General Medicine & Geriatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;; College of Medicine Chang Gung University, Taoyuan, Taiwan.
College of Medicine Chang Gung University, Taoyuan, Taiwan;
出版信息
J Thorac Dis. 2017 Jan;9(1):123-128. doi: 10.21037/jtd.2017.01.25.
BACKGROUND
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is rare, with better clinical outcomes than other lung cancers. However, reports on advanced LELC characteristics and prognosis are lacking.
METHODS
This retrospective study included adults diagnosed with advanced LELC (at least stage IIIA) between January 2003 and December 2015. Clinical characteristics, treatment modalities, and outcomes were recorded.
RESULTS
Study population comprised 23 patients with a mean age of 63.7±10.6 years. The Eastern Cooperative Oncology Group status on diagnosis was 0 in five patients and 1 in the others. Most patients received multimodality treatment and all received cisplatin-based chemotherapy. Median follow-up duration was 28.8 months. The median progression free survival (PFS) was 14.6 months in patients received palliative chemotherapy. There were nine (39.1%) deaths. The median overall survival (OS) was not achieved. Until July 31, 2016, median OS was 54.1 months for stage IIIB and 27.6 months for stage IV. There was no significant difference in OS among all stages. No prognostic factors were found.
CONCLUSIONS
Advanced LELC responded well to cisplatin-based chemotherapy and/or radiotherapy. Main tumor resection is probably beneficial for advanced LELC. Long-term survival is possible for advanced LELC after multimodality treatment.
背景
原发性肺淋巴上皮瘤样癌（LELC）较为罕见，其临床预后优于其他肺癌。然而，关于晚期LELC特征和预后的报道较少。
方法
这项回顾性研究纳入了2003年1月至2015年12月期间诊断为晚期LELC（至少IIIA期）的成年患者。记录临床特征、治疗方式和结局。
结果
研究人群包括23例患者，平均年龄为63.7±10.6岁。诊断时东部肿瘤协作组状态为0的患者有5例，其余患者为1。大多数患者接受了多模式治疗，所有患者均接受了以顺铂为基础的化疗。中位随访时间为28.8个月。接受姑息化疗的患者中位无进展生存期（PFS）为14.6个月。有9例（39.1%）死亡。未达到中位总生存期（OS）。截至2016年7月31日，IIIB期患者的中位OS为54.1个月，IV期患者为27.6个月。各阶段之间的OS无显著差异。未发现预后因素。
结论
晚期LELC对以顺铂为基础的化疗和/或放疗反应良好。主要肿瘤切除可能对晚期LELC有益。晚期LELC经多模式治疗后有可能长期生存。
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