【摘要】 背景与目的:小细胞肺癌由于生长迅速,确诊时常已出现远处转移,而化疗成为其主要的治疗方法,但单纯化疗常因原发灶或纵隔淋巴结复发而导致治疗失败。本研究探讨综合外科手术治疗局限期小细胞肺癌能否有效地控制原发灶并提高其疗效。方法:回顾分析我院1981年5月至2001年5月接受手术治疗的51例局限期小细胞肺癌患者的临床资料。结果:按照1997年国际肺癌分期标准,Ⅰb期7例(占13.7%),Ⅱa期5例(9.8%),Ⅱb期15例(29.4%),Ⅲa期20例(39.2%),Ⅲb期4例(7.8%)。全肺切除12例,肺叶切除35例,楔形切除3例,探查术1例。13例单纯手术治疗,38例结合2～6疗程的术前或术后化疗。全组中位生存期为20.8个月,1、3、5年生存率分别为43.0%、25.9%和20.1%。Ⅰb期患者1、3、5年生存率分别为100.0%、80.0%和30.0%;Ⅱ期患者1、3、5年生存率分别为79.7%、39.8%和34.5%;Ⅲ期患者1、3、5年生存率分别为52.4%、21.8%和5.46%。手术结合化疗组1、3、5年生存率分别77.5%、38.5%和23.8%;单纯手术组1、3、5年生存率分别为41.7%、16.7%和8.3%,两组比较差异有显著性(P<0.01)。结论:综合外科手术治疗能提高局限期小细胞肺癌的生存率,可作为临床选用的治疗方法之一。更多还原

【Abstract】 BACKGROUND &OBJECTIVE: Small cell lung cancer (SCLC) is usually widely disseminated at the time of diagnosis due to its rapid growth. Therefore chemotherapy is the predominant form of treatment for SCLC. However, chemotherapy normally ended in failure as a consequence of recurrence of primary tumor or mediastinal lymphatic nodes. The objective of this study was to investigate whether combined surgical treatment for SCLC can control primary tumor more effectively and increase the survival of the patients. METHODS: Fifty one cases of limited SCLC treated with surgery from May 1981 to May 2001 in Cancer Center, Sun Yat sen University were reviewed retrospectively. RESULTS: According to 1997 international staging system, there were 7 patients with stage ⅠB(13.7%),5 with stage ⅡA(9.8%),15 with stage ⅡB (29.4%),20 with stage ⅢA (39.2%) and 4 with stage ⅢB (7.8%). Twelve patients received pneumonectomy, 35 lobectomy, 3 segmentectomy, and 1 exploration. Thirteen patients were treated with surgery alone and 38 of them combined with 2 6 cycles of pre or post operative chemotherapy. The median survival time was 20.8 months. The overall 1 , 3 , and 5 year survival rates were 43.0%, 25.9%, and 20.1%, respectively. The 1 , 3 , and 5 year survival rates for patients with stage ⅠB were 100.0%, 80.0%, and 30.0%respectively, with stage Ⅱwere 79.7%, 39.8%, and 34.5%, respectively, with stage Ⅲwere 52.4%,21.8%,and 5.46%,respectively. The 1 ,3 ,and 5 year survival rates for patients treated by surgery combined with chemotherapy were 77.5%,38.5%,and 23.8%and that of surgery alone were 41.7%,16.7%, and 8.3%,respectively (P< 0.01). CONCLUSION: Combined surgical treatment can increase the survival rate of SCLC more effectively and should be considered as an important modality in multi disciplinary treatment of limited small cell lung cancer.更多还原