Clinical efficacy and prognostic factors of intensity-modulated radiotherapy combined with chemotherapy for limited-stage small cell lung cancer
10.3760/cma.j.issn.1004-4221.2018.03.006
- VernacularTitle:IMRT下局限期SCLC放化疗疗效及预后分析
- Author:
Xuan LIU
1
;
Zongmei ZHOU
;
Yuxia WANG
;
Xin DONG
;
Dongfu CHEN
;
Zefen XIAO
;
Qinfu FENG
;
Jima LYU
;
Jun LIANG
;
Xiaozhen WANG
;
Zhouguang HUI
;
Lyuhua WANG
;
Yexiong LI
;
Weibo YIN
Author Information
1. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院放疗科
- Keywords:
Carcinoma;
small cell lung/intensity modulated radiotherapy;
Combined modality therapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2018;27(3):256-260
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy and prognosis of intensity-modulated radiotherapy(IMRT)combined with chemotherapy for limited-stage small cell lung cancer(LS-SCLC). Methods A retrospective analysis was performed on the clinical data of 484 LS-SCLC patients treated with chemoradiotherapy in our center from 2006 to 2014. The patients with partial or complete response to IMRT received prophylactic cranial irradiation(PCI). The Kaplan?Meier method was used to calculate survival rates, and the log-rank test and Cox regression were used for univariate and multivariate analyses, respectively. Results In all the patients, the follow-up rate was 93%;the median overall survival(OS) time was 23.8 months;the 2-,3-,and 5-year OS rates were 48.7%,39.8%,and 28.6%,respectively;the median progression-free survival(PFS)time was 14.1 months;the 2-, 3-, and 5-year PFS rates were 34.4%,30.5%, and 28.3%, respectively. The incidence rates of grade ≥3 bone marrow suppression, grade ≥2 radiation esophagitis, and grade ≥2 radiation pneumonitis were 26.9%, 24.8%, and 18.4%, respectively, in SCLC patients after IMRT. The objective response rate was 84.5%. The univariate analysis showed that age, smoking history, TNM stage, PCI, and the number of chemotherapy cycles before radiotherapy were prognostic factors for OS(P= 0.006, 0.001, 0.047, 0.000, and 0.046). The multivariate analysis showed that smoking history and PCI were independent prognostic factors(P=0.001 and 0.000).Conclusions IMRT combined with chemotherapy achieves satisfactory clinical outcomes in the treatment of LS-SCLC. Smoking history and PCI are independent prognostic factors for OS of LS-SCLC patients.
