Hitchins R N, Phillips J, Woods R L
Royal North Shore Hospital, NSW.
Aust N Z J Med. 1988 Feb;18(1):3-7. doi: 10.1111/j.1445-5994.1988.tb02231.x.
We assessed outcome in 208 patients with small cell lung carcinoma two to seven years after treatment with combination chemotherapy, with or without chest and cranial radiotherapy. Fourteen patients (6.7%) survived cancer free for 30 months or longer. Nine of these (64%) had limited disease at diagnosis and four others had extensive disease with only one metastatic site. Two patients remain alive and disease free more than five years after diagnosis but median survival is still only 3.2 years. One patient died from intercurrent causes at 5.4 years but was free from small cell lung carcinoma at autopsy. Six patients are alive and disease free at intervals greater than 30 months but less than five years from diagnosis. All surviving patients are fully active with lifestyles similar to that prior to diagnosis. Five patients died from small cell lung carcinoma which relapsed more than 30 months after diagnosis. A few patients with small cell lung carcinoma are cured but 30-month survival is insufficient to show cure as late relapses do occur. Late toxicity from aggressive therapy does not appear to outweigh the benefits of long-term survival and potential cure in small cell lung carcinoma.
我们评估了208例接受联合化疗（无论是否联合胸部和颅脑放疗）治疗两至七年的小细胞肺癌患者的预后情况。14例患者（6.7%）无癌生存30个月或更长时间。其中9例（64%）诊断时为局限性疾病，另外4例为广泛性疾病但仅有一个转移部位。2例患者在诊断后五年多仍存活且无疾病，但中位生存期仍仅为3.2年。1例患者在5.4岁时死于并发疾病，但尸检时无小细胞肺癌。6例患者存活且无疾病，诊断后间隔时间大于30个月但小于五年。所有存活患者均完全活跃，生活方式与诊断前相似。5例患者死于小细胞肺癌复发，复发时间在诊断后30多个月。少数小细胞肺癌患者可治愈，但30个月的生存期不足以证明治愈，因为确实会发生晚期复发。积极治疗的晚期毒性似乎并未超过小细胞肺癌长期生存和潜在治愈的益处。
