标题：放疗联合化疗治疗局限期小细胞肺癌的临床疗效及预后影响因素研究

      作者：苏云涛 1，朱勇 1，胡志纲 1，任建 1，何荣华 2，田宁强 3    宝鸡市中心医院放射治疗科 1、医学影像科 2、综合内科 3，陕西 宝鸡 721008

      卷次： 2019年30卷11期

      【摘要】 目的 观察放疗联合化疗治疗局限期小细胞肺癌(LSCLC)的临床疗效，并探讨其预后的影响因素。方法 选择宝鸡市中心医院放射治疗科 2012年 2月至 2015年 3月收治的LSCLC患者 226例，给予放疗联合化疗治疗，观察患者疗效及治疗过程中发生的不良反应，分析其与临床特征的相关性，同时分析影响预后的相关因素。结果 226例患者经治疗后完全缓解 131例，部分缓解 63例，无变化 27例，疾病进展 5例，有效率为85.8% (194/226)；患者中位生存时间23.2个月，1年生存率为66.4% (150/226)，2年生存率为31.0% (70/226)，3年生存率为15.0% (34/226)；患者主要不良反应为骨髓抑制、放射性食管炎、放射性肺炎、胃肠道反应，其中≥3级的骨髓抑制发生率为44.6%，≥3级胃肠道反应发生率为28.3%，≥2级的放射性食管炎发生率为35.8%，有临床症状的放射性肺炎发生率为11.5%；单因素分析发现，年龄、是否吸烟、PS评分、肿瘤体积均为患者预后的相关因素(P<0.05)；Logistic回归分析发现，年龄、是否吸烟、PS评分、肿瘤体积是影响患者预后的独立影响因素(P<0.05)。结论 LSCLC采用放疗联合化疗治疗可获得较好疗效，患者年龄、是否吸烟、PS评分值，肿瘤体积大小是影响预后的主要因素。
      【关键词】 局限期小细胞肺癌；放疗；化疗；疗效；预后
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2019）11—1385—03

Clinical efficacy and prognostic factors of radiotherapy combined with chemotherapy for localized small cell lungcancer.
SU Yun-tao 1, ZHU Yong 1, HU Zhi-gang 1, REN Jian 1, HE Rong-hua 2, TIAN Ning-qiang 3. Department ofRadiotherapy 1, Department of Medical Imaging 2, Department of Comprehensive Internal Medicine 3, Baoji Central Hospital,Baoji 721008, Shaanxi, CHINA
【Abstract】 Objective To discuss the clinical effects and the prognosis-influencing factors of radiotherapycombined with chemotherapy for localized small cell lung cancer (LSCLC). Methods From February 2012 to March2015, 226 patients with LSCLC in Department of Radiotherapy, Baoji Central Hospital were treated with radiotherapycombined with chemotherapy. The clinical effects, side effects were observed, and the clinical characteristics of the pa-tients were analyzed. The prognostic factors were analyzed by single and multiple factors, and the results were com-pared. Results Among the 226 patients, there were 131 patients of complete remission, 63 patients of partial remis-sion, 27 patients of no change, 5 patients of disease progression, with the effective rate of 85.8% (194/226). The mediansurvival time of patients was 23.2 months. The 1-year survival rate was 66.4% (150/226), 2-year survival rate was31.0% (70/226), and the 3-year survival rate was 15.0% (34/226). The main adverse reactions were myelosuppression,radiation esophagitis, radiation pneumonia, and gastrointestinal tract reactions. The incidence of myelosuppression (≥grade 3), gastrointestinal reaction (≥grade 3), radiation esophagitis (≥grade 2), and radiation pneumonia with clini-cal symptoms were 44.6%, 28.3%, 35.8%, 11.5%, respectively. Univariate analysis showed that age, smoking or not,PS score, and tumor volume were all related factors of prognosis (P<0.05). Logistic regression analysis showed thatage, smoking or not, PS score, and tumor volume were independent factors influencing prognosis of patients (P<0.05). Conclusion LSCLC can get ideal curative effect by radiotherapy combined with chemotherapy. Age, smokingor not, PS score, and tumor size are the main factors affecting the prognosis of LSCLC.
      【Key words】 Limited-stage small cell lung cancer (LSCLC); Radiotherapy; Chemotherapy; Curative effect; Prognosis