中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (1): 45-51.doi: 10.19401/j.cnki.1007-3639.2021.01.006

• 论著 • 上一篇    下一篇

不同转移部位对广泛期小细胞肺癌患者治疗预后的影响

刘 倩 1 ,乔 梦 1 ,毛士琦 1 ,杨 硕 1 ,刘弋维 1 ,赵 超 2 ,李雪飞 2 ,任胜祥 1 ,周彩存 1   

  1. 1. 同济大学附属上海市肺科医院肿瘤科,上海 200433 ;
    2. 同济大学附属上海市肺科医院肺癌免疫研究室,上海 200433
  • 出版日期:2021-01-30 发布日期:2021-02-22
  • 通信作者: 任胜祥 E-mail: harry_ren@126.com
  • 基金资助:
    国家自然科学基金(81772467);上海市肺科医院骨干计划(FKGG1802)。

Impact of metastatic organ on prognosis in extensive-stage small cell lung cancer

LIU Qian 1 , QIAO Meng 1 , MAO Shiqi 1 , YANG Shuo 1 , LIU Yiwei 1 , ZHAO Chao 2 , LI Xuefei 2 , REN Shengxiang 1 , ZHOU Caicun 1 #br#   

  1. 1. Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China; 2. Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
  • Published:2021-01-30 Online:2021-02-22
  • Contact: REN Shengxiang E-mail: harry_ren@126.com

摘要: 背景与目的:小细胞肺癌(small cell lung cancer,SCLC)是肺癌中恶性程度最高的病理学类型,易发生远处转移,转移部位及肿瘤负荷对患者的预后有一定预测作用。比较不同远处转移部位及转移器官个数对广泛期SCLC患者预后的影响,以期为临床决策提供参考。方法:收集2014年5月—2019年2月在同济大学附属上海市肺科医院就诊的广泛期SCLC患者的临床资料,回顾性分析其远处转移部位及转移器官个数与患者总生存期(overall survival,OS)及疗效的关系。结果:206例广泛期SCLC患者中,大部分(69.0%)患者在诊断初期就已发生远处转移,转移器官个数越多,中位OS越短(P=0.007 9),中位无进展生存期(progression-free survival,PFS)也越短(P=0.027 0)。脑转移、骨转移、对侧肺转移、肝转移及其他器官转移组中位OS分别为14.83、11.70、14.47、11.10及12.47个月(P=0.031 1)。脑转移、骨转移、对侧肺转移、肝转移及其他器官转移组中位PFS分别为5.07、4.07、7.10、3.87及4.80个月(P=0.033 6)。结论:广泛期SCLC患者远处转移提示预后差,转移器官个数越多,OS及PFS越差。在不同器官转移中,肝转移及骨转移患者OS及PFS较差,提示预后不良。

关键词: 广泛期小细胞肺癌, 器官转移, 生存时间

Abstract: Background and purpose: Small cell lung cancer (SCLC) is the most malignant pathological type of lung cancer, and is prone to distant metastasis. The site of metastasis and tumor burden can predict the prognosis. The purpose of this study was to compare impacts of the different sites of distant metastasis and the number of metastatic organs on the prognosis of extensive- stage SCLC patients to provide reference for clinical decision. Methods: Clinical data of extensive-stage SCLC patients from May 2014 to February 2019 in Shanghai Pulmonary Hospital, Tongji University were collected, and the relationship between the sites of distant metastasis / the number of metastatic organs and overall survival (OS)/therapeutic efficacy was retrospectively analyzed. Results: Most of patients (69.0%) had distant metastasis at the initial diagnosis. The greater the number of metastatic organs, the shorter the median OS (P=0.007 9) and progression-free survival (PFS) (P=0.027 0). The median OS of patients with brain metastasis, bone metastasis, contralateral lung metastasis, liver metastasis and other organ metastasis were 14.83, 11.70, 14.47, 11.10 and 12.47 months, respectively (P=0.031 1). The median PFS of patients with brain metastasis, bone metastasis, contralateral lung metastasis, liver metastasis and other organ metastasis were 5.07, 4.07, 7.10, 3.87 and 4.80 months, respectively (P=0.033 6). Conclusion: Distant metastasis in patients with extensive-stage SCLC suggests poor prognosis, and the more metastatic organs, the worse the OS and PFS. Patient with liver and bone metastases has worse OS and PFS suggesting poor prognosis.

Key words: Extensive-stage small cell lung cancer, Organ metastasis, Survival time