Chen X, Li S, Zuo D, Liu S, Bai L, Yian D, Huang Z
Department of Thoracic Surgery, Beijing Chest Tumor and Tuberculosis Institute.
Chin Med J (Engl). 1995 Sep;108(9):689-91.
From 1975 through 1990, 199 patients with limited small cell lung cancer (LSCLC) were subjected to multimodality treatment including surgical resection combined with chemotherapy or chemoradiotherapy in our department. The median postoperative survival time of the 199 patients was 39 months, and the 5-year survival rate was 26%, which was decreased with increase of tumor-stage. In comparison of the survival time of patients in Stage I and those in Stage IIIa, there was a significant difference (P < 0.01). There were no significant differences in survival rate of 3 and 5 years between the patients receiving chemotherapy prior to or after surgical resection. The improvement in survival was documented by surgical resection combined with chemotherapy or chemoradiotherapy for LSCLC. The effect of multimodality treatment is correlated with tumor P-TNM staging, the involvement of lymph node, especially that of the mediastinal lymph node, is a negative factor influencing the prognosis. Surgical resection is an initial management, followed by chemotherapy or chemoradiotherapy may be indicated in LSCLC patients of Stage I, Stage II and some Stage IIIa as the cancer can be resected completely.
1975年至1990年期间,我科对199例局限期小细胞肺癌(LSCLC)患者进行了多模式治疗,包括手术切除联合化疗或放化疗。这199例患者的术后中位生存时间为39个月,5年生存率为26%,且随着肿瘤分期的增加而降低。比较Ⅰ期和Ⅲa期患者的生存时间,差异有统计学意义(P < 0.01)。手术切除前或后接受化疗的患者3年和5年生存率无显著差异。手术切除联合化疗或放化疗可改善LSCLC患者的生存情况。多模式治疗的效果与肿瘤P-TNM分期相关,淋巴结受累,尤其是纵隔淋巴结受累,是影响预后的负面因素。手术切除是初始治疗手段,对于Ⅰ期、Ⅱ期及部分Ⅲa期的LSCLC患者,若肿瘤能够完全切除,术后可进行化疗或放化疗。