91例小细胞肺癌预后的回顾性多因素分析

BACKGROUND AND OBJECTIVE: Small cell lung cancer accounts for about 15%-25% of lung cancer, although the new chemotherapy drugs and radiation technology are continuously progressing, but the prognosis is still poor.To explore the prognostic factor of small cell lung cancer (SCLC), we study the correlation between effect, prognosis and TNM stage, various treatment mode. METHODS: We collected 91 Limited-disease-SCLC patients'data From 2006 to 2012.The data were reviewed retrospectively and restaged as Ⅰ, Ⅱ, Ⅲa and Ⅲb stage groups according to the clinical staging in the seventh edition of the tumor.We compare the progression-free survival (FPS) and overall survival (OS).Survival analysis was evaluated by Kaplan-Meier and multivariate analysis was performed by Cox proportional hazards model. RESULTS: In the whole group, patients achieved complete response and partial response, exhibited an RR of 93.4%.The median PFS was 14.25 months of which, 22.03 months in patients in stage Ⅰ, 15.97 months in stage Ⅱ, 11.99 months in stage Ⅲa and 10.5 months in stage Ⅲb (P < 0.05).The median overall survival (OS) was 19.56 months of which, 33.38 months in patients in stage Ⅰ, 22.07 months in stage Ⅱ, 16.0 months in stage Ⅲa and 15.52 months in stage Ⅲb (P < 0.05).Patients of stage Ⅲa and Ⅲb have longer survival time in earlier radiation groups then that of later radiation groups.Univariate analysis indicate stage of TNM, the pattern of radiation therapy and chemotherapy cycles before radiation therapy were significantly related to the survival in SCLC.Multivariate analysis showed that stage of TNM, ECOG (Eastern Cooperative Oncology Group) performance status, pattern of radiation therapy and cycle numbers of chemotherapy before radiation were factors correlated with survival. CONCLUSION: The stage of TNM may become beneficial prognostic factors in the treatment of LD-SCLC.The time of radiation therapy in stage Ⅲa and Ⅲb is of worth further investigation.