Background and objective: Studies on combined small cell lung cancer (C-SCLC), which shows continuously increasing incidence, are rare. Accordingly, we explored the relationship between the clinicopathological characteristics and prognostic factors of C-SCLC patients and analyzed the treatment of this disease.
Methods: Between January 2006 and December 2011, 80 patients with pathologically confirmed C-SCLC were retrospectively analyzed. The Kaplan-Meier methods were used to calculate the survival rate, and the Log-rank test was used to examine differences between arms. The Cox regression model was used to analyze the independent factors affecting the overall survival (OS).
Results: The OS of the C-SCLC patients in all groups had a median of 26.2 mo and a range of 0.3 to 81.4 mo. In univariate analysis, gender, Karnofsky performance score before treatment, tumor diameter, and tumor stage were the considered prognostic factors affecting the OS rate of the C-SCLC patients (P<0.05). Cox multivariate analysis showed that only the TNM stage was the independent prognostic factor influencing the OS of the C-SCLC patients. The majority (75.0%) of the patients received multimodality therapy and platinum-based chemotherapy as the main treatment. However, no significant differences in OS rate were observed between patient groups under conventional SCLC regimens and non-SCLC regimens (P>0.05).
Conclusions: C-SCLC is a specific mixed carcinoma. Combined therapy with platinum-based chemotherapy as the main treatment should be adopted in the therapeutic regimen of this disease. TNM stage was the independent prognostic factor influencing the OS of C-SCLC patients. .
背景与目的 复合型小细胞肺癌(combined small cell lung cancer, C-SCLC)的检出率逐年增高,但其相关报道仍较少,本研究探讨C-SCLC的临床病理特征与预后的关系,分析其治疗现状。方法 回顾性分析2006年1月-2011年12月间80例病理证实的C-SCLC患者的资料,采用Kaplan-Meier法计算生存率,Log-rank法进行单因素预后分析,Cox风险回归模型分析影响总生存(overall survival, OS)的因素。结果 全组的OS为0.3个月-81.4个月,中位OS为26.2个月。单因素分析显示:性别、治疗前卡氏评分、肿瘤直径、分期是影响OS的预后因素(P<0.05)。多因素分析显示,只有TNM分期是独立的影响OS的因素(P=0.015)。全组多数患者(75.0%)采取综合模式治疗,以铂类药物为基础的联合化疗是主要的治疗方法,采用SCLC的化疗方案或非小细胞肺癌的方案对患者生存的影响无统计学意义(P>0.05)。结论 C-SCLC是一种特殊类型的肺混合性癌,治疗应采用以铂类为基础的化疗为主的综合治疗模式,TNM分期是独立的预后影响因素。.