Dou Xuejun, Wang Zhiyuan, Wang Liang, Lu Weiqiang, Ma Yunlei, Xu Shaofa
Department of Thoracic Surgery, Aerospace Central Hospital, Beijing 100049, China.
Department of Thoracic Surgery, Beijing Chest Hospital, Beijing 101149, China.
Zhongguo Fei Ai Za Zhi. 2017 Feb 20;20(2):88-92. doi: 10.3779/j.issn.1009-3419.2017.02.03.
Small cell lung cancer (SCLC) accounts for nearly 15% of all cases of cancer. As a type of highly invasive tumors, SCLC has high degree of malignancy, early and extensive metastasis, and is sensitive to chemotherapy and radiotherapy. The early treatment response rate of SCLC is high but it can also relapse rapidly without any treatment. Its median survival time is merely four to six months. Although many studies on SCLC have been conducted in recent years, its clinical treatment strategies have remained unchanged. The treatment of SCLC is still confined to chemotherapy regimens of etoposide plus cisplatin (EP) and other classic treatments because the surgical treatment of SCLC, particularly for IIIa treatment, has yet to reach a consensus. This study investigated the prognostic factors and clinical therapy effect in the comprehensive treatment of IIIa SCLC after surgical treatment.
This study was conducted through the retrospective analysis of the clinical data of 78 patients with SCLC who underwent surgical treatment in Beijing Chest Hospital affiliated to Capital Medical University between January 1995 and December 1995. Through follow-up, we performed statistical analysis of each patient's gender, age, tumor size, lymph node metastasis, tumor-node-metastasis (TNM) staging, surgical methods, and adjuvant radiation and chemotherapy.
The median survival in this clinical trial team was 13.93 months. Among the participants, 47 patients accepted neoadjuvant chemotherapy and their median survival were 14.25 months. By contrast, 31 patients accepted postoperative adjuvant chemotherapy and their median survival were 13.83 months. No statistical difference was observed between the two groups. Moreover, 28 patients were of single Lymph node metastasis and their median survival was 17.1 months. By contrast, 50 patients were of multiple lymph node metastasis and their median survival was 11.9 months. Significant statistical difference was observed between the two groups (P<0.01).
In performing further evaluation of the status and value of surgical treatment in the comprehensive treatment of SCLC, several patients benefitted from IIIa SCLC surgery with comprehensive treatment.
小细胞肺癌（SCLC）占所有癌症病例的近15%。作为一种高度侵袭性肿瘤，SCLC恶性程度高，早期广泛转移，对化疗和放疗敏感。SCLC的早期治疗缓解率高，但未经任何治疗也可迅速复发。其平均生存时间仅为4至6个月。尽管近年来对SCLC进行了许多研究，但其临床治疗策略仍未改变。SCLC的治疗仍局限于依托泊苷加顺铂（EP）的化疗方案及其他经典治疗，因为SCLC的手术治疗，特别是Ⅲa期的治疗，尚未达成共识。本研究探讨了Ⅲa期SCLC手术治疗后综合治疗的预后因素及临床治疗效果。
本研究通过回顾性分析1995年1月至1995年12月在首都医科大学附属北京胸科医院接受手术治疗的78例SCLC患者的临床资料。通过随访，对每位患者的性别、年龄、肿瘤大小、淋巴结转移、肿瘤-淋巴结-转移（TNM）分期、手术方式以及辅助放化疗进行了统计分析。
该临床试验组的中位生存期为13.93个月。参与者中，47例患者接受了新辅助化疗，其中位生存期为14.25个月。相比之下，31例患者接受了术后辅助化疗，其中位生存期为13.83个月。两组之间未观察到统计学差异。此外，28例患者为单个淋巴结转移，其中位生存期为17.1个月。相比之下，50例患者为多个淋巴结转移，其中位生存期为11.9个月。两组之间观察到显著的统计学差异（P<0.01）。
在进一步评估手术治疗在SCLC综合治疗中的地位和价值时，部分Ⅲa期SCLC患者通过综合治疗的手术获益。
