Objective:The aim of the study was to explore the effects and side effects of induction chemotherapy followed by chemoradiotherapy for limited-disease small cell lung cancer (LD-SCLC) patients with ipsilateral pleural...Objective:The aim of the study was to explore the effects and side effects of induction chemotherapy followed by chemoradiotherapy for limited-disease small cell lung cancer (LD-SCLC) patients with ipsilateral pleural effusion.Methods:From January 2005 to May 2009,52 LD-SCLC patients with ipsilateral pleural effusion were treated with induction chemotherapy first.The regimen was taken as follows:etoposide 100 mg iv,d1-d5,cisplatin 25 mg/m2 iv,d1-d3 or CBP AUC 4 iv,d1.Three-week therapy was a cycle.According to pleural effusion status after 2-4 cycles induction chemotherapy,patients got disappearance of pleural effusion after chemotherapy were underwent thoracic radiotherapy (TRT;50 Gy/25 fraction) or same chemotherapy regimen;patients without disappearance or with increasing of pleural effusion after chemotherapy were given same chemotherapy regimen.Therapeutic effect was evaluated every two cycles according to RECIST 1.0 and side-effects were evaluated every cycle according to NCI-CTC AE Grades.All patients were followed up,and the median follow-up time was 26 months.Results:The response rate of patients was 80.7% (42/52) after induction chemotherapy and 34 patients got disappearance of pleural effusion.The median survival time,1-and 2-year survival rates were 15.4 months,76.9% (40 /52) and 38.5% (20 /52) respectively.The median survival time,1-and 2-year survival rates of patients with pleural effusion remission received chest radiotherapy (A group,n=20),patients with pleural effusion remission received chemotherapy (B group,n=14) and patients without pleural effusion remission received chemotherapy (C group,n=18) were 21.5 months,14.4 months,12.5 months,80.0%,64.3%,55.6% and 35%,21.4%,11.1%,respectively.Main side effects were grades 1-2,including myelosuppression,fatigue,nausea and vomiting.No therapeutic related death was occurred.Conclusion:Induction chemotherapy plus chemoradiotherapy has shown better effect in prolonging survival of small cell lung cancer (SCLC) patients with ipsilateral pleural effusion than chemotherapy alone.The patients with decreased ipsilateral pleural effusion may receive benefit from subsequent TRT.展开更多
文摘Objective:The aim of the study was to explore the effects and side effects of induction chemotherapy followed by chemoradiotherapy for limited-disease small cell lung cancer (LD-SCLC) patients with ipsilateral pleural effusion.Methods:From January 2005 to May 2009,52 LD-SCLC patients with ipsilateral pleural effusion were treated with induction chemotherapy first.The regimen was taken as follows:etoposide 100 mg iv,d1-d5,cisplatin 25 mg/m2 iv,d1-d3 or CBP AUC 4 iv,d1.Three-week therapy was a cycle.According to pleural effusion status after 2-4 cycles induction chemotherapy,patients got disappearance of pleural effusion after chemotherapy were underwent thoracic radiotherapy (TRT;50 Gy/25 fraction) or same chemotherapy regimen;patients without disappearance or with increasing of pleural effusion after chemotherapy were given same chemotherapy regimen.Therapeutic effect was evaluated every two cycles according to RECIST 1.0 and side-effects were evaluated every cycle according to NCI-CTC AE Grades.All patients were followed up,and the median follow-up time was 26 months.Results:The response rate of patients was 80.7% (42/52) after induction chemotherapy and 34 patients got disappearance of pleural effusion.The median survival time,1-and 2-year survival rates were 15.4 months,76.9% (40 /52) and 38.5% (20 /52) respectively.The median survival time,1-and 2-year survival rates of patients with pleural effusion remission received chest radiotherapy (A group,n=20),patients with pleural effusion remission received chemotherapy (B group,n=14) and patients without pleural effusion remission received chemotherapy (C group,n=18) were 21.5 months,14.4 months,12.5 months,80.0%,64.3%,55.6% and 35%,21.4%,11.1%,respectively.Main side effects were grades 1-2,including myelosuppression,fatigue,nausea and vomiting.No therapeutic related death was occurred.Conclusion:Induction chemotherapy plus chemoradiotherapy has shown better effect in prolonging survival of small cell lung cancer (SCLC) patients with ipsilateral pleural effusion than chemotherapy alone.The patients with decreased ipsilateral pleural effusion may receive benefit from subsequent TRT.
