|本期目录/Table of Contents|

[1]孙基峰,罗 婧,徐利明,等.广泛期小细胞肺癌肝转移治疗模式探讨[J].天津医科大学学报,2019,25(06):577-580.
 SUN Ji-feng,LUO Jing,XU Li-ming,et al.Discussion on the treatment mode of liver metastasis in patients with extensive small cell lung cancer[J].Journal of Tianjin Medical University,2019,25(06):577-580.
点击复制

广泛期小细胞肺癌肝转移治疗模式探讨(PDF)
分享到:

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

卷:
25
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-boWANG 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 metastasesprognosistreament
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.

参考文献/References:

[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in china, 2015[J]. CA Cancer J Clin, 2016,66(2):115
[2] Yip D, Harper P G. Predictive and prognostic factors in small cell lung cancer: current status [J]. Lung Cancer, 2000,28(3):173
[3] Parikh M, Riess J, Lara P N Jr. New and emerging developments in extensive-stage small cell lung cancer therapeutics[J]. Curr Opin Oncol, 2016, 28(2):97
[4] Li X X, Li R J, Zhao L J, et al. Expression of molecular factors correlated with metastasis in small cell lung cancer and their significance [J]. Int J Clin Exp Pathol, 2015,8(11):14676
[5] Han Y, Yan D, Xu F, et al. Radiofrequency ablation versus liver resection for colorectal cancer liver metastasis: an updated systematic review and meta-analysis[J]. Chin Med J(Engl), 2016,129(24): 2983
[6] Mochimaru T, Minematsu N, Ohsawa K, et al. Hemoperitoneum secondary to rupture of a hepatic metastasis from small cell lung cancer during chemotherapy: a case with a literature review[J]. Intern Med, 2017, 56(6): 695
[7] Quint L E, Tummala S, Brisson L J, et al. Distribution of distant metastases from newly diagnosed non-small cell lung cancer[J]. Ann Thorac Surg, 1996,62(1):246
[8] de Jong M C, Pulitano C, Ribero D, et al. Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients [J]. Ann Surg, 2009, 250(3): 440
[9] Aloia T A, Vauthey J N, Loyer E M, et al. Solitary colorectal liver metastasis: resection determines outcome[J]. Arch Surg, 2006, 141(5): 460
[10] Ileana E, Greillier L, Moutardier V, et al. Surgical resection of liver non-small cell lung cancer metastasis: a dual weapon?[J]. Lung Cancer, 2010,70(2): 221
[11] Nagashima A, Abe Y, Yamada S, et al. Long-term survival after surgical resection of liver metastasis from lung cancer[J]. Jpn J Thorac Cardiovasc Surg, 2004, 52(6): 311
[12] Van Cutsem E, Nordlinger B, Adam R, et al. Towards a pan-european consensus on the treatment of patients with colorectal liver metastases [J]. Eur J Cancer, 2006, 42(14): 2212
[13] Choi J, Bischof J C. Review of biomaterial thermal property measurements in the cryogenic regime and their use for prediction of equilibrium and non-equilibrium freezing applications in cryobiology [J]. Cryobiology, 2010, 60(1):52
[14] Eickmeyer F, Schwarzmaier H J, Muller F P, et al. survival after laser-induced interstitial thermotherapy of colorectal liver metastases-a comparison of first clinical experiences with current therapy results [J]. Rofo, 2008,180(1):35
[15] Curley S A, Marra P, Beaty K, et al. Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients [J]. Ann Surg, 2004,239(4):450
[16] Cho Y K, Kim J K, Kim W T, et al. Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: A markov model analysis [J]. Hepatology, 2010,51(4):1284
[17] Fukushima K, Kido M, Fukumoto T, et al. a case report of intrahepatic cholangiocarcinoma diagnosed as lung cancer with liver metastasis treated with radiofrequency ablation[J]. Gan To Kagaku Ryoho, 2011,38(12):2030
[18] Kennedy A S. Radiation oncology approaches in liver malignancies[J]. Am Soc Clin Oncol Educ Book, 2014:e150-5. doi: 10.14694/EdBook_AM.2014.34.e150.
[19] Caivano D, Valeriani M, Russo I, et al. Stereotactic body radiation therapy in primary and metastatic liver disease[J]. Anticancer Res, 2017,37(12):7005
[20] Evrard S, Rivoire M, Arnaud J, et al. Unresectable colorectal cancer liver metastases treated by intraoperative radiofrequency ablation with or without resection [J]. Br J Surg, 2012,99(4):558
[21] Mariani P, Almubarak M M, Kollen M, et al. Radiofrequency ablation and surgical resection of liver metastases from uveal melanoma[J]. Eur J Surg Oncol, 2016,42(5):706
[22] Hu X, Zhang F, Liu X R, et al. Efficacy and potential microrna mechanism for computed tomography-guided percutaneous radiofrequency ablation of primary lung cancer and lung metastasis from liver cancer [J]. Cell Physiol Biochem, 2014,33(5):1261
[23] Gutkin P M, Hiniker S M, Swetter S M,et al. Complete response of metastatic melanoma to local radiation and immunotherapy: 6.5 Year Follow-Up[J]. Cureus, 2018, 10(12): e3723
[24] Mochimaru T, Minematsu N, Ohsawa K, et al. Hemoperitoneum secondary to rupture of a hepatic metastasis from small cell lung cancer during chemotherapy: a case with a literature review[J]. Intern Med, 2017, 56(6): 695

相似文献/References:

[1]李家腾,宋世辉,王 田,等.小细胞肺癌患者化疗前后CEA、NSE和CYFRA21-1的变化对评估预后的作用[J].天津医科大学学报,2014,20(06):448.
 LI Jia-teng,SONG Shi-hui,WANG Tian,et al.Effect of Changes of CEA, NSE and CYFRA21-1 before and after chemotherapy on the evaluation of prognosis in patients with small cell lung cancer[J].Journal of Tianjin Medical University,2014,20(06):448.
[2]王子乔,张雪茜,孟凡荣,等.小鼠小细胞肺癌模型的建立[J].天津医科大学学报,2018,24(01):29.
 WANG Zi-qiao,ZHANG Xue-xi,MENG Fan-rong,et al.Establishment of a mouse model of pulmonary small cell lung cancer[J].Journal of Tianjin Medical University,2018,24(06):29.
[3]张姝阳,张家丽,赵 宁,等.IP方案与CAO方案二线治疗复发小细胞肺癌的疗效及毒副作用比较研究[J].天津医科大学学报,2018,24(05):415.
 ZHANG Shu-yang,ZHANG Jia-li,ZHAO Ning,et al.Comparison of the efficacy and toxicity between the IP regimen and the CAO regimen in the second line treatment for recurrent small cell lung cancer[J].Journal of Tianjin Medical University,2018,24(06):415.
[4]董傲然,张家丽,任秀宝,等.促胃泌素释放肽前体对小细胞肺癌的诊断价值[J].天津医科大学学报,2019,25(03):234.
 DONG Ao-ran,ZHANG Jia-li,REN Xiu-bao,et al.Diagnosis value of pro-gastrin-releasing peptide precursor for small cell lung cancer[J].Journal of Tianjin Medical University,2019,25(06):234.
[5]赵军华,邱鸣寒,袁智勇.射波刀治疗小细胞肺癌脑转移的疗效分析[J].天津医科大学学报,2019,25(04):346.
 ZHAO Jun-hua,QIU Ming-han,YUAN Zhi-yong.The effectiveness of CyberKnife for brain metastases from small cell lung cancer[J].Journal of Tianjin Medical University,2019,25(06):346.
[6]胡 雪 综 述,张新伟 审 校.小细胞肺癌合并低钠血症的研究进展[J].天津医科大学学报,2019,25(04):422.

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。
更新日期/Last Update: 2020-01-20