晚期细支气管肺泡癌的临床特点和化学治疗

目的 分析晚期细支气管肺泡癌（BAC）的临床特点以及化学治疗的临床价值。方法收集我院1999年1月至2004年12月期间经病理或细胞学证实为晚期BAC的53例患者临床资料,大部分患者采用以铂类为基础的联合化疗至少2个周期。结果 53例患者中,女性34例（64,2％）,不吸烟者42例（79,2％）,发生于右肺者29例,12例患者表现为多发病灶或弥漫侵犯。化疗有效率为17．0％,其中2例（3,8％）获完全缓解,7例（13,2％）获部分缓解,30例（56．6％）患者病情稳定,14例（26,4％）病情进展。中位肿瘤无进展生存时间和中位生存时间分别为6．1个月和16,0个月,1年生存率为71,7％。Ⅲ～Ⅳ度的毒副反应主要包括中性粒细胞减少（34.0％）、血小板减少（15．1％）、贫血（22．6％）、恶心和呕吐（39．6％）、脱发（30．2％）、便秘（17．0％）和外周神经毒性（13．2％）等。结论 晚期BAC好发于女性、不吸烟者,以右肺多见,似有多发病灶或双肺弥漫侵犯。以铂类为基础的联合化疗对晚期BAC疗效尚可,毒副反应可以耐受。与历史同期别的肺腺癌相比,BAC有着更好的1年生存率和总生存时间。

Clinical characteristics and chemotherapy of advanced-stage bronchioloalveolar carcinoma of the lung: report of 53 patients

Objective To analyze the clinical feature and the value of chemotherapy for advanced stage bronchioloalveotar carcinoma(BAC)of the lung.Methods The clinical data of 53 advanced stage BAC patients treated from Jan.1999 to Dec.2004 was collected and reviewed.Most of the patients received more than 2 cycles of the combined chemotherapy with platinum-based regimen.Results Of these 53 eligible patients in this series,34(64,2%)were women,42(79.2%)never smoked any cigarette,29 (54.7%)originated from the right lung,and 12 patients(22.6%)showed bilateral multi-lobular or multi- central lesions or diffusive pulmonary involvement.The objective response rate was 17.0%(2 complete response,7 partial response).30(56.6%)patients demonstrated stable disease and 14(26.4%)patients showed progression of the disease.The median progression-free and overall survivals were 6.1 and 16.0 months,respectively.The 1-year survival rate was 71.7%.Grade 3 or severer toxicities included neutropenia(34.0%),thrombocytopenia(15.1%),anemia(22.6%),nausea and vomiting(39.6%), alopecia(30.2%),constipation(17.0%)and peripheral neurotoxicity(13.2%).Conclusion Advanced bronchioloalveolar carcinoma is likely to occur in woman,nonsmoker and the right lung,frequently with bilateral diffuse pulmonary involvement.The platinum-based combined chemotherapy regimen is modestly effective with tolerable toxicity.Compared with the historical data of lung adenocarcinoma of the same stage, bronchioloalveolar carcinoma has a longer overall survivd.