Department of Respiratory Medicine, Shanghai Pudong New Area People's Hospital, Shanghai, China.
J BUON. 2021 May-Jun;26(3):812-818.
The aim of this study was to compare the efficacy of surgery combined with conventional chemoradiotherapy in the treatment of limited-stage small cell lung cancer (LS-SCLC), and analyze the factors affecting prognosis.
A total of 122 LS-SCLC patients were diagnosed via histopathology, of which 61 were operated combined with chemoradiotherapy (comprehensive treatment group), and 61 underwent conventional chemoradiotherapy (chemoradiotherapy group). The Kaplan-Meier method wand log-rank test were used to analyze the overall survival of the patients. Cox proportional hazard regression model was utilized for multivariate analysis of prognosis.
The median survival time of the patients was 27 months in the comprehensive treatment group and 22 months in chemoradiotherapy group. The 1-, 3- and 5-year survival rates were 91.8% (56/61), 49.2% (30/61) and 31.1% (19/61), respectively, in the comprehensive treatment group, and 80.3% (49/61), 32.8% (20/61) and 23.0% (14/61), respectively, in the chemoradiotherapy group. The results of log-rank test on the overall survival rate of the two groups of patients revealed that the overall survival rate was overtly higher in the comprehensive treatment group than that in the chemoradiotherapy group. According to stratification analysis of the TNM stage, the 1-, 3- and 5-year survival rates of the patients with stage I + II LS-SCLC were evidently higher in the comprehensive treatment group than those in the chemoradiotherapy group. Multivariate analysis results uncovered that the clinical TNM stage was an independent factor affecting the survival time of the patients.
Surgery combined with chemoradiotherapy may benefit the patients with stage I and II LS-SCLC, while radiotherapy combined with chemotherapy is more suitable for the patients at stage III. TNM stage is an independent factor affecting the prognosis of LS-SCLC.
本研究旨在比较手术联合常规放化疗治疗局限期小细胞肺癌（LS-SCLC）的疗效，并分析影响预后的因素。
共 122 例 LS-SCLC 患者经组织病理学诊断，其中 61 例接受手术联合放化疗（综合治疗组），61 例接受常规放化疗（放化疗组）。采用 Kaplan-Meier 法和对数秩检验分析患者的总生存情况。采用 Cox 比例风险回归模型进行预后的多因素分析。
综合治疗组患者的中位生存时间为 27 个月，放化疗组为 22 个月。综合治疗组 1、3、5 年生存率分别为 91.8%（56/61）、49.2%（30/61）和 31.1%（19/61），放化疗组分别为 80.3%（49/61）、32.8%（20/61）和 23.0%（14/61）。两组患者总生存率的对数秩检验结果显示，综合治疗组的总生存率明显高于放化疗组。根据 TNM 分期的分层分析，Ⅰ+Ⅱ期 LS-SCLC 患者的 1、3、5 年生存率明显高于放化疗组。多因素分析结果显示，临床 TNM 分期是影响患者生存时间的独立因素。
手术联合放化疗可能对Ⅰ+Ⅱ期 LS-SCLC 患者有益，而放疗联合化疗更适合Ⅲ期患者。TNM 分期是影响 LS-SCLC 预后的独立因素。
