中国肺癌杂志2018，Vol.21Issue(1)：16-23,8.DOI:10.3779/j.issn.1009-3419.2018.01.03
局限期小细胞肺癌合并胸水临床特点及预后因素分析
Analysis of Prognostic Factors and Clinical Characteristics for Patients with Limited Stage Small Cell Lung Cancer with Pleural Effusion
许昆鹏 1王优优 1齐静 1赵路军 1王平1
作者信息
- 1. 300060 天津,天津医科大学肿瘤医院放疗科,国家肿瘤临床医学研究中心 天津市"肿瘤防治"重点实验室 天津市恶性肿瘤临床医学研究中心
- 折叠
摘要
Abstract
Background and objective Malignant pleural effusion (PE) was generally defined as pleural effusion containing tumors with poor prognosis. Some kinds of undefined pleural effusions due to too small amount of effusion had poor prognosis too. This study aimed to analyze the clinical characteristics and prognostic factors of patients who suffered from limited-stage small cell lung cancer (LS-SCLC) complicated with pleural effusion. Methods A retrospective analysis included 542 patients who were diagnosed with LS-SCLC and had treatment in our hospital from October 2007 to January 2016. We had observed 109 patients who were diagnosed with pleural effusion at their first visit to the doctor. We analyzed the clinical characters, survival time and the prognostic factors of the 109 patients. Our main observation targets were overall survival (OS) and progression free survival (PFS). Results The median OS and PFS of whole group were 29.4 and 18.2 months. Before treatment,survival time of patients with PE were significantly shorter than patients without PE (median OS: 21.0 vs 31.7 months;median PFS: 14.1 vs 9.1 months; Log-rank, P=0.001, P=0.014). Multi-factor analysis of multivariate Cox shows PE was the independent prognostic factor of LS-SCLC (P=0.04). Single factor analysis showed factors affecting PE patient's survival time included clinical stages, lymph node (LN) stages, KPS scores, pulmonary atelectasis and the state of pleural after treatment. Cox multi-factor analysis reminded that the state of pleural effusion after treatment was the independent prognostic factor of LSSCLC complicated with pleural effusion (P=0.016). There were three groups was apportioned patients without pleural effusion before treatment (group 1; n=433), patients whose pleural effusion disappeared after treatment (group 2; n=67) and patients whose pleural effusion didn't disappear after treatment (group 3; n=32).The median OS were 31.7, 23.2, 16.8 months in the group 1, 2, 3 and the median PFS were 19.1, 17.9, 11.4 months. Obvious difference was noted by the comparison of survival time of these three groups (Log-rank P<0.001, P<0.002). The difference between group 2 and group 3 was significant (Log-rank P=0.046, P=0.013) while no obvious difference was noted during comparison of group 1 and group 2. For patients who have LS-SCLC complicated with PE, there is no remarkable difference between chemoradiotherapy and chemotherapy alone. Conclusion The survival time of patients who suffered from limited-stage small cell lung cancer complicated with pleural effusion was obviously shortened. The disappearing of pleural effusion after treatment was the independent favorable prognostic factor of survival. How to treat needed further investigation.关键词
局限期/小细胞肺癌/胸腔积液/预后Key words
Limited-stage/Small cell lung cancer/Pleural effusion/Prognosis引用本文复制引用
许昆鹏,王优优,齐静,赵路军,王平..局限期小细胞肺癌合并胸水临床特点及预后因素分析[J].中国肺癌杂志,2018,21(1):16-23,8.
