442例局限期小细胞肺癌综合治疗分析

目的：通过局限期小细胞肺癌先化疗后放射治疗（先化后放组）和化疗＋放射治疗＋化疗（化放化组）2个组的疗效比较，分析影响预后因素。方法：局部期小细胞肺癌442例随机分为先化后放组（228例）和化疗化组（214例）。先化后放组为化疗4周期后放射治疗，化疗化组为化疗2周期后放射治疗1个疗程再化疗2周期。放射治疗技术和剂量两组相同，大多数病例总量DT50－70Gy,5-7周，照射野包括原发灶，肺门、纵隔及双锁骨上淋巴引流区，化疗方案有COMP、COMVP和CECAP。结果：全组总有效率为78．1％，局部复发率分别为34．6％和35．0％，2个组远地转移率分别为57．5％和57．9％。结论：2个组的近期疗效。长期生存，局部复发率和远地转移均无统计学差异。

Combined therapy for 442 patients with limited small cell lung cancers

Objective To compare the survival rates of sequential versus alternating modalities of rad iotherapy and chemotherapy for li mited small cell lung cancer (SCLC). Methods From January 1983 to December 1995 , 442 patients with limited SCLC were randomized into two groups: 228 patients i n the sequential arm ( S ), 214 patients in the alternating arm (A ). Radiation was started after two cycles of chemotherapy in arm A and after the fourth cycle in arm S. All patients received conventional radiotherapy. The total tumor dose was 50-70 ?Gy/5-7 weeks. The radiation fields covered the primary tumo r, draining hilar lymphatics, partial mediastinum and bilateral supraclavicular are as. Results The overall response rate ( CR +PR ) was 78.1%. The median surviva l time was 15.6 months in arm S, and 12.0 months in arm A. The 1-, 3 - and 5- yea r survival rates were 54.5%, 20.9% , 17.1% in arm S, and 65.1%,18.3% , 17.6% in arm A (P=0.69). The frequencies of l ocal recurrence were 34.6% and 35.0% , and distant metastasis were 57.5% and 5 7.9% in arms S and A. Conclusion No obvious differencie is observed in comparin g the survival, recurrence and metastasis between arm A and arm B in the presen ted study.