Shen G H, Lin T H, Hsu W H, Chiang C D
Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1995 Mar;11(3):133-41.
Plain chest film is the most convenient and common tool used to evaluate the response of lung cancer to chemotherapy. Many authors tried to evaluate the use of plain chest films to predict chemotherapy response. This study investigated a new factor which could be used to predict the chemotherapy response of small cell lung cancer (SCLC).
Sixty-two patients with cytopathologically proven small cell lung cancer receiving at least two courses of chemotherapy were included in this study. Among these patients, thirty-nine patients received six courses of chemotherapy. The regimens of chemotherapy are Etoposide (100 mg/m2) and Cisplatin (25 mg/m2). We divided these patients into two groups according to whether a well-defined pulmonary lesion excluding hilar and mediastinal lymphoadenopathy, could be identified on plain chest X-ray (CXR). Group I consisted of 31 patients with identified lesions on the CXR; group II consisted of 31 patients with unidentifiable lung lesions. CXRs were taken each time before chemotherapy and were collected and compared to evaluate the chemotherapy response. The 39 patients receiving six course of chemotherapy, were further divided into group I (n = 19) and group II (n = 20) to evaluate the chemotherapy response.
After two courses of chemotherapy, we found 23 patients [74.2% (23/31)] in group I had partial response(PR) as compared to 12 patients [38.7% (12/31)] in group II (P < 0.05). For the 39 patients receiving six courses of chemotherapy, we could find only five patients [16.1% (5/19)] in group I who had a complete response (CR) as compared to 17 patients [85% (17/20)] in group II (P < 0.001).
For patients with SCLC, a well-defined lung lesion on a CXR could be an important new factor to predict the chemotherapy response. It could predict less responsiveness to chemotherapy.
胸部平片是评估肺癌化疗反应最便捷且常用的工具。许多作者尝试评估胸部平片在预测化疗反应方面的应用。本研究调查了一个可用于预测小细胞肺癌（SCLC）化疗反应的新因素。
本研究纳入了62例经细胞病理学证实为小细胞肺癌且接受至少两个疗程化疗的患者。其中，39例患者接受了六个疗程的化疗。化疗方案为依托泊苷（100mg/m²）和顺铂（25mg/m²）。根据胸部X线平片（CXR）上能否识别出明确的肺部病变（不包括肺门和纵隔淋巴结肿大），将这些患者分为两组。第一组由31例CXR上有明确病变的患者组成；第二组由31例无法识别肺部病变的患者组成。每次化疗前拍摄CXR，并收集和比较以评估化疗反应。对接受六个疗程化疗的39例患者，进一步分为第一组（n = 19）和第二组（n = 20）以评估化疗反应。
两个疗程化疗后，我们发现第一组中有23例患者[74.2%（23/31）]出现部分缓解（PR），而第二组中为12例患者[38.7%（12/31）]（P < 0.05）。对于接受六个疗程化疗的39例患者，我们发现第一组中只有5例患者[16.1%（5/19）]达到完全缓解（CR），而第二组中有17例患者[85%（17/20）]（P < 0.001）。
对于SCLC患者，CXR上明确的肺部病变可能是预测化疗反应的一个重要新因素。它可预测化疗反应性较低。
