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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年06期

页码:

577-580

栏目:

临床医学

出版日期:

2019-11-20

文章信息/Info

Title:

Discussion on the treatment mode of liver metastasis in patients with extensive small cell lung cancer

文章编号:

1006-8147(2019)06-0577-04

作者:

孙基峰; 罗 婧; 徐利明; 赵路军; 司同国; 陈思颖; 刘宁波; 王 平

（天津医科大学肿瘤医院放疗科, 国家肿瘤临床医学研究中心, 天津市肿瘤防治重点实验室, 天津市恶性肿瘤临床医学研究中心, 天津 300060）

Author(s):

SUN Ji-feng;  LUO Jing;  XU Li-ming;  ZHAO Lu-jun;  SI Tong-guo;  CHEN Si-ying;  LIU Ning-bo; WANG Ping

（Department of Radiation Oncology , Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China）

关键词:

小细胞肺癌; 肝转移; 预后; 治疗

Keywords:

small cell lung cancer;  liver metastases; prognosis; treament

分类号:

R734.2

DOI:

-

文献标志码:

A

摘要:

目的：探讨广泛期小细胞肺癌肝转移患者不同治疗模式预后。方法：回顾分析2012-2016年本院收治的80例广泛期小细胞肺癌（SCLC）伴肝转移患者，根据治疗方法不同分为肝脏转移灶放疗联合全身化疗组，单纯全身化疗组以及射频消融（RFA）联合全身化疗组。Kaplan-Meier计算生存率，Logrank和ANOVA检验差异。结果：全组80例患者中位生存期为8.5个月，肝脏转移灶放疗联合化疗组中位总生存期（OS）为8.5个月，全身化疗组中位OS为6.9个月，射频消融（RFA）联合全身化疗组中位OS为10.7个月。接受RFA联合全身化疗组患者生存优于其他两组（P<0.001）。RFA组患者和放疗组患者局控时间相当（8.0个月vs. 9.1个月，P=0.188），均明显优于单纯化疗组（4.6个月）。结论：RFA联合全身化疗治疗小细胞肺癌肝转移可有效延长局控时间和总生存期；转移灶放疗联合全身化疗同样有效延长局控时间，但生存获益不明显。对于一般状态良好的患者，可考虑在全身化疗的基础上行RFA治疗，RFA不能耐受的患者推荐肝脏转移灶调强放疗。

Abstract:

Objective: To investigate the different treatment outcome of extensive stage small cell lung cancer (ES-SCLC) patients with liver metastasis. Methods：A retrospective analysis was performed in 80 extensive-stage SCLC patients with liver metastases who were admitted to our hospital from 2012 to 2016. All patients received standard EP/CE (etoposide+cisplatin/carboplatin) chemotherapy. According to different treatment, patients were divided into radiotherapy group (n=26), chemotherapy group (n=30) and RFA group(n=24). The survival rates were analyzed using the Kaplan-Meier method. Between-group comparison was made by log-rank test and one-way ANOVA. Results：In all the patients, the median overall survival(OS) were 8.5 months. The RFA radiotherapy group had significantly longer median OS than the radiotherapy group and chemotherapy group(10.7 vs. 8.5 and 6.9 months, P<0.001). The RFA group and radiotherapy group had similar LRFS(9.1vs 8.0 months), which is longer than that in the chemotherapy group (4.6 months). Conclusion：RFA combined with systemic chemotherapy can effectively prolong the local control time and overall survival time for of ES-SCLC patients with liver metastases. Radiotherapy combined with systemic chemotherapy can also effectively prolong the local control time, but the survival benefit is not obvious. For patients in good condition, RFA should be considered, and IMRT for liver metastases is recommended for patients with intolerance of RFA.

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备注/Memo

备注/Memo:

基金项目 国家自然科学基金（81372518）；天津市科委面上项目（16JCYBJC25300）
作者简介 孙基峰（1992-），男，硕士在读，研究方向：肿瘤放射治疗学；通信作者: 刘宁波，E-mail：liuningbo@tjmuch.com。

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更新日期/Last Update: 2020-01-20