Cancer 2011 Dec;117 (23): 5423-31. [IF:5.131]
Thoracic radiation therapy improves the overall survival of patients with extensive-stage small cell lung cancer with distant metastasis.
Zhu H , Zhou Z , Wang Y , Bi N , Feng Q , Li J , Lv J , Chen D , Shi Y , Wang L .
Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
中国医学科学院中国协和医科大学，北京肿瘤医院肿瘤放疗科
Abstract
The authors conducted a retrospective study to evaluate the effects of thoracic radiation therapy (TRT) for patients with extensive-stage small cell lung cancer (ED-SCLC). Between January 2003 and December 2006, the records of 119 patients who were diagnosed with ED-SCLC (all with distant metastasis [M1]) were included in the study. Sixty patients received chemotherapy (ChT) and TRT (ChT/TRT), and 59 patients received ChT alone. The ChT regimens consisted of either carboplatin and etoposide (CE) or cisplatin and etoposide (PE). The total dose of TRT ranged from 40 to 60 grays (Gy) at 1.8 to 2.0 Gy per fraction. For the entire group, the median survival was 13 months, and the 2-year and 5-year overall survival (OS) rates were 26.1% and 6.5%, respectively. The median survival and the 2-year and 5-year OS rates were 17 months, 35%, and 7.1%, respectively, in the ChT/TRT group and 9.3 months, 17%, and 5.1%, respectively, in the ChT group (P = .014). However, this improvement was achieved at the expense of low toxicity. Multivariate analysis revealed that receiving ≥4 cycles of ChT (P = .032) and TRT (P = .005) were favorable prognostic factors for OS. Of all toxicities, only high-grade leucopenia (grade >3) was more frequent in the ChT/TRT group. The addition of TRT to ChT improved the OS of patients with ED-SCLC. Furthermore, receiving ≥4 cycles of ChT and TRT were independent, favorable prognostic factors for OS. Cancer 2011;. ? 2011 American Cancer Society.
摘要：
研究者进行了一项回顾性的研究以评价胸部放疗(TRT)对广泛期小细胞肺癌(ED-SCLC)病人的疗效。从2003年1月至2006年12月，共有119个病人被诊断为广泛期小细胞肺癌(ED-SCLC)，所有的病人都有远处转移（M1期），这119个病人被纳入到此项研究中。60个病人接受了化疗(ChT)联合胸部放疗(ChT/TRT)，另外59个病人仅接受了单纯的化疗(ChT)。化疗方案包括卡铂+依托泊苷(CE)或者顺铂+依托泊苷(PE)。总的胸部放疗剂量达到40~60Gy，常规分割剂量为1.8~2.0Gy。所有病人的中位生存时间为13个月，2年生存率为26.1%，5年生存率为6.5%。化疗联合胸部放疗组(ChT/TRT)的中位生存时间为17个月，2年生存率为35%，5年生存率为7.1%；单纯化疗组(ChT) 中位生存时间为9.3个月，2年生存率为17%，5年生存率为5.1%(P = .014)。然而，这些优势的获得并未因为增加了胸部放疗而使得患者承受了更大的毒副作用。多因素分析显示接受不少于4个周期化疗ChT (P = .032)和胸部放疗TRT (P = .005)是有利于提高5年生存率的预后因素。在各种毒副作用中，仅白细胞减少（三级）在化疗联合放疗组中发作频繁。化疗联合胸部放疗能够提高广泛期小细胞肺癌(ED-SCLC)的总生存期。更确切的说，接受不少于4个周期的化疗和胸部放疗是有利于总生存期提高的独立的、有益的预后因素。
