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早期小细胞肺癌患者手术与非手术治疗的短期和长期疗效评估:一项对比研究。

Evaluation of short-term and long-term efficacy of surgical and non-surgical treatment in patients with early-stage small cell lung cancer: A comparative study.

作者信息

Hou Shi-Zhen, Cheng Zi-Ming, Wu Yu-Bing, Sun Yi, Liu Bing, Yuan Mao-Xi, Wang Xiang-Dong

出版信息

Cancer Biomark. 2017 Jul 4;19(3):249-256. doi: 10.3233/CBM-160332.

Abstract

OBJECTIVE

The aim of this study is to compare surgery with adjuvant chemoradiotherapy versus non-surgical treatments for patients with early-stage small cell lung cancer (SCLC) based on the short-term and long-term efficacy.

METHODS

SCLC patients who underwent a pulmonary lobectomy with post-surgical radiotherapy or chemotherapy were assigned to the surgical group. SCLC patients who received radiotherapy or chemotherapy alone were classified into the non-surgical group. The clinical efficacy was evaluated as complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD). The total effectiveness rate was calculated as CR + PR. The 1-, 3-, and 5-year survival rates of the two groups were compared.

RESULTS

Compared with the non-surgical group, the CR rate and the total effectiveness rate were higher in the surgical group, and the total effectiveness rate for male patients and patients without a smoking history were also higher in the surgical group. Distant metastasis and local recurrence concurrent with distant metastasis in the surgical group were both lower in the surgical group than in the non-surgical group. Compared with the non-surgical group, the local recurrence in male patients was lower in the surgical group, and patients in the surgical group had lower distant metastasis at TNM stage IIb. The 1-, 3-, and 5-year survival rates were higher in the surgical group than in the non-surgical group.

CONCLUSIONS

These findings indicate that for patients with early-stage SCLC, better scores in effectiveness rate, disease progression, and 1-, 3-, and 5-year survival rates were observed in patients who underwent surgery followed by adjuvant chemoradiotherapy when compared with patients without surgical treatment.

摘要

目的

本研究旨在基于短期和长期疗效,比较早期小细胞肺癌(SCLC)患者手术联合辅助放化疗与非手术治疗的效果。

方法

接受肺叶切除术后放疗或化疗的SCLC患者被分配到手术组。仅接受放疗或化疗的SCLC患者被分类到非手术组。临床疗效评估为完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)或疾病进展(PD)。总有效率计算为CR + PR。比较两组的1年、3年和5年生存率。

结果

与非手术组相比,手术组的CR率和总有效率更高,手术组男性患者和无吸烟史患者的总有效率也更高。手术组的远处转移以及远处转移合并局部复发均低于非手术组。与非手术组相比,手术组男性患者的局部复发更低,且手术组患者在TNM IIb期的远处转移更低。手术组的1年、3年和5年生存率高于非手术组。

结论

这些发现表明,对于早期SCLC患者,与未接受手术治疗的患者相比,接受手术联合辅助放化疗的患者在有效率、疾病进展以及1年、3年和5年生存率方面表现更佳。

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