INFLUENCE OF SURGICAL RESECTION BEFORE AND AFTER CHEMOTHERAPY ON SURVIVAL IN SMALL-CELL LUNG-CANCER
INFLUENCE OF SURGICAL RESECTION BEFORE AND AFTER CHEMOTHERAPY ON SURVIVAL IN SMALL-CELL LUNG-CANCER
复制标题
DOI：
10.1002/jso.2930470112
复制
发表时间：
1991-05-01
影响因子：
2.5
通讯作者：
KAWASAKI, M
中科院分区：
文献类型：
--
作者：
HARA, N;OHTA, M;KAWASAKI, M
我们试图确定手术在小细胞肺癌（SCLC）治疗中的作用。在81例临床局限性SCLC患者中，36例接受了手术切除：19例接受了首次切除术和术后化疗，而其余17例接受了首次化疗，然后切除。其余45例患者接受化疗和放疗联合治疗。36例手术患者的5年生存率为38%，中位生存时间（MST）为33个月。19例术后化疗患者的5年生存率为42%，而17例术前化疗患者的5年生存率为33%。这种差异不显著。然而，术前化疗患者（MST，29个月）的III期生存率往往优于仅接受术后化疗的患者（MST，17个月）。虽然45例非手术患者的生存率很低，但I期和II期患者或完全缓解患者的5年生存率分别为25%和21%，MST分别为33个月和25个月。因此，我们得出结论，初步切除术结合术后化疗是有益的患者与I期，可能是II期疾病。对于可切除的III期，尤其是N2期患者，化疗后辅助切除可能是治疗SCLC的有利选择。对于晚期III期患者，应尝试通过化疗完全缓解并联合放疗。
We attempted to define the role of surgery in the treatment of small cell lung cancer (SCLC). Of 81 patients with clinically localized SCLC, 36 underwent surgical resection: 19 underwent initial resection with postoperative chemotherapy, while the remaining 17 were treated initially with chemotherapy, then resection. The remaining 45 patients were treated with a combination of chemotherapy and radiotherapy. The 5-year survival for the 36 surgical patients was 38%; median survival time (MST) was 33 months. Ninteen patients treated with postoperative chemotherapy showed a 42% 5-year survival, while 17 patients treated with preoperative chemotherapy showed at 33% 5-year survival. This difference was not significant. However, stage III survival tended to be better in patients with preoperative chemotherapy (MST, 29 months) than in those who had had postoperative chemotherapy only (MST, 17 months). Although survival of the 45 nonsurgical patients was poor, state I and II patients, or those with complete remission showed a 25% 5-year survival with an MST of 33 months, and a 21% 5-year survival with an MST of 25 months, respectively. We thus concluded that initial resection combined with postoperative chemotherapy is beneficial for patients with stage I, and probably stage II disease. For resectable stage III, particularly in patients with N2 disease, adjuvant resection after chemotherapy may be a favorable choice in the management of SCLC. For advanced stage III, complete remission by chemotherapy should be attempted in combination with radiotherapy.