不同介入时机预防性全脑照射对局限期 小细胞肺癌疗效的影响

Curative effect of prophylactic cranial irradiation at different timing of intervention on limited-stage small cell lung cancer

摘要:

目的 分析不同介入时机预防性全脑照射（PCI）对局限期小细胞肺癌（LSCLC）交替放化疗完 全缓解（CR）后脑转移率和生存率的影响。方法 对该院90 例LSCLC 患者进行回顾性分析，将其分为短周 期组（51 例），长周期组（39 例）。两组均进行胸部放疗、化疗（依托泊苷+ 顺铂）2 个周期。短周期组化疗 2 个周期后给予PCI 治疗；而长周期组化疗4 个周期后给予PCI 治疗，并比较两组脑转移率和生存率。结果 短周期组3 年内脑转移率为12/51（23.53%），长周期组为20.51%（8/39）；两组3 年内脑转移率比较，差异无 统计学意义（P >0.05）。短周期组第1、2 及3 年总生存率分别为82.35%、39.22% 及21.57%，中位生存时间 为15 个月；长周期组第1、2 及3 年总生存率分别为76.92%、43.59% 和23.08%，中位生存时间为18 个月。 两组第1、2 及3 年总生存率比较，差异无统计学意义（P >0.05）。短周期组第1、2 及3 年局部无进展生存率分 别为54.90%、19.61% 和15.69%，长周期组分别为66.67%、23.08% 和12.82%，且两组中位局部无进展生存期均 为16 个月。两组第1、2 及3 年局部无进展生存比较，差异无统计学意义（P >0.05）。两组不良反应发生率、肿 瘤复发及转移发生率比较，差异无统计学意义（P >0.05）。结论 采取不同介入时机PCI 对LSCLC 交替放化疗 CR 后脑转移率和生存率较为接近，无较大差异。

Abstract:

Objective To analyze the effects of prophylactic cranial irradiation on brain metastasis rate and survival rate in patients with limited-stage small cell lung cancer on alternate chemoradiotherapy after complete remission (CR) at different interventional time. Methods A retrospective analysis of 90 patients with limited-stage small cell lung cancer in our hospital, they were divided into the short-period group (51 cases) and long-period group (39 cases). 90 cases were given radiotherapy, Etoposide + Cisplatin chemotherapy for 2 cycles; the prophylactic cranial irradiation was given after 2 cycles of Etoposide + Cisplatin chemotherapy in the short-period group, while the prophylactic cranial irradiation therapy was given after 4 cycles of Etoposide + Cisplatin chemotherapy in the long-period group. The brain metastasis rate and survival rate were compared between the two groups. Results The brain metastasis rate in short-period group within 3 years was 23.53% (12/51) and 20.51% (8/39) in the long-period group; the brain metastasis rate in 3 years showed no significantly difference between the two groups (P > 0.05). The overall survival rates after 1, 2, 3 years in the short-period group were 82.35%, 39.22% and 21.57% and the median survival time was 15 months; the overall survival rates of 1, 2, 3 years in the long-period group were 76.92%, 43.59% and 23.08% and the median survival time was 18 months. The overall survival rates after 1, 2, 3 years showed no significant difference between the two groups (P > 0.05). The local progression free survival rates after 1, 2, 3 years in the short-period group were 54.90%, 19.61% and 15.69%, and 66.67%, 23.08% and 12.82% in the long-period group. The median progression free survival time of the two groups was 16 months. The local progression free survival after 1, 2, 3 years showed no significant difference between the two groups (P > 0.05). The incidence rate of adverse reactions, tumor recurrence and metastasis showed no significant difference between the two groups (P > 0.05). Conclusion The different intervention times of prophylactic cranial irradiation of alternate chemoradiotherapy after CR in patients with limited-stage small cell lung cancer are close to the brain metastasis rate and survival rate, which isn’t significant difference.