Chen Hao, Ishihara Masashi, Horita Nobuyuki, Kazahari Hiroki, Ochiai Ryusuke, Tanzawa Shigeru, Honda Takeshi, Ichikawa Yasuko, Watanabe Kiyotaka, Seki Nobuhiko
Division of Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan.
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama 236-0027, Japan.
Cancers (Basel). 2021 Nov 26;13(23):5948. doi: 10.3390/cancers13235948.
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subset of lung carcinoma with poor overall survival.
A systematic review following a meta-analysis of studies was performed to identify the effect of different selections of chemotherapy in LCNEC. Articles providing overall survival data for adjuvant chemotherapy or palliative chemotherapy for LCNEC were eligible. The odds ratio (OR) of mortality at one or two years after chemotherapy was evaluated.
A total of 16 reports were finally included in the quantitative synthesis, involving a total of 5916 LCNEC patients. Adjuvant chemotherapy was administered to 1303 patients, and palliative chemotherapy was administered to 313 patients using either a small cell lung cancer (SCLC) or a non-small cell lung cancer (NSCLC) regimen. The OR for adjuvant chemotherapy was 0.73 (95% confidence interval (CI): 0.59 to 0.89, = 0.002). The SCLC regimen showed an OR of 0.52 (95% CI: 0.11 to 2.38, = 0.40) after one year, and 0.32 (95% CI: 0.11 to 0.89, = 0.03) after two years, compared with the NSCLC regimen.
Adjuvant chemotherapy for pulmonary large cell neuroendocrine carcinoma improved the outcome after surgery. The SCLC regimen showed better survival than the NSCLC regimen as palliative chemotherapy.
肺大细胞神经内分泌癌（LCNEC）是肺癌中一种罕见的亚型，总体生存率较差。
在对研究进行荟萃分析之后进行了一项系统评价，以确定不同化疗方案对LCNEC的影响。提供LCNEC辅助化疗或姑息化疗总生存数据的文章符合要求。评估化疗后1年或2年死亡率的比值比（OR）。
共有16份报告最终纳入定量分析，共涉及5916例LCNEC患者。1303例患者接受了辅助化疗，313例患者使用小细胞肺癌（SCLC）或非小细胞肺癌（NSCLC）方案接受了姑息化疗。辅助化疗的OR为0.73（95%置信区间（CI）：0.59至0.89，P = 0.002）。与NSCLC方案相比，SCLC方案在1年后的OR为0.52（95%CI：0.11至2.38，P = 0.40），2年后为0.32（95%CI：0.11至0.89，P = 0.03）。
肺大细胞神经内分泌癌的辅助化疗改善了手术后的预后。作为姑息化疗，SCLC方案的生存率优于NSCLC方案。
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