【摘要】 目的 分析和评估预防性全脑照射（PCI）及放化疗后疗效对局限期小细胞肺癌患者脑转移率和生存率的影响。方法 回顾性选取2011年1月至2013年12月于复旦大学附属肿瘤医院及闵行分院接受同步放化疗的95例局限期小细胞肺癌患者，其中63例放化疗后疗效评价为完全缓解（CR）或部分缓解（PR）的患者行PCI治疗，32例患者未行PCI治疗。分析比较PCI组及未行PCI组，CR组及PR组的脑转移率及生存率。结果 两组在性别、吸烟、TNM分期、放疗分割模式、诱导化疗周期数方面比较无统计学差异（P> 0.05），而PCI组年龄明显低于未行PCI组，差异有显著性（P <0.05）。PCI组1年、3年及5年生存率分别为96.8%、55.4%和39.1%，未行PCI组分别为78.1%、26.2%和19.6%，两组生存差异具有显著统计学意义（P <0.05）。PCI组2年脑转移率为6%，明显低于未行PCI组的44.1%(P <0.05)。行PCI治疗的患者中，CR和PR患者分别有23例（36.5%）和40例（63.5%）。CR组2年及5年生存率分别为73.9%和46.2%,2例患者发生脑转移（8.7%）,PR组2年及5年生存率分别为72.5%和37.5%,7例发生脑转移（17.5%），两组生存及脑转移率差异均无显著统计学意义（P> 0.05）。结论 PCI能减少LSSCLC脑转移率，延长患者生存期。放化疗后达CR者行PCI后，其生存率及脑转移率未显著优于PR者。更多还原

【Abstract】 Objective To evaluate the efficacy of prophylactic cranial irradiation(PCI) and curative effect of chemoradiotherapy on the survival and brain metastasis in patients with limited-stage small cell lung cancer(LS-SCLC). Methods Data of 95 patients with LS-SCLC who had undergone concurrent chemoradiotherapy between January 2011 and December 2013 at Fudan University Shanghai Cancer Center and Minhang Branch, Fudan University Shanghai Cancer Center were analyzed. Sixty-three patients with complete response(CR) and partial response(PR) after concurrent chemoradiotherapy received PCI. Thirty-two had no PCI. The survival and brain metastasis rates were compared between PCI group and non-PCI group, CR group and PR group who received PCI. Results There was no statistical difference between the two groups in gender,smoking, TNM stage, radiotherapy fractionation mode, and the number of cycles of induction chemotherapy(P>0.05). The 1, 3, 5-year survival rates were 96.8%, 55.4%, 39.1% in the PCI group and 78.1%, 26.2%, 19.6% in the non-PCI group, with the significant difference between the two groups(P<0.05). The 2-year brain metastasis rate was 6% in the PCI group, which was significantly lower than 44.1% in the non-PCI group(P<0.05). Among the patients who received PCI, 23 cases(36.5%) and 40 cases(63.5%) had CR and PR, respectively. The 2, 5-year survival rates were 73.9% and 46.2%, and brain metastasis occurred in 2 patients(8.7%) in the CR group. The 2-year, 5-year survival rates were 72.5%and 37.5%, and brain metastasis occurred in 7 patients(17.5%) in the PR group. The difference of survival and brain metastasis rates between two groups were not statistically significant(P>0.05). Conclusion PCI can decrease the brain metastasis rate and prolong survival in LSSCLC. The survival and brain metastasis rates of CR patients after chemoradiotherapy who received PCI were not significantly better than that of PR patients.更多还原