| Shuonan Xu,Jianfei Zhu,Yawei Dou,Wei Tian,Yun Dai,Xianghui Luo,Hongtao Wang. Analysis of long-term outcomes and application of the tumor regression grading system in the therapeutic assessment of resectable limited-disease small cell lung cancer. Oncol Transl Med, 2016, 2: 227-233. |
| 对于可切除的局限期小细胞肺癌的预后分析及肿瘤退缩分级的应用 |
| Analysis of long-term outcomes and application of the tumor regression grading system in the therapeutic assessment of resectable limited-disease small cell lung cancer |
| Received:March 24, 2016 Revised:August 10, 2016 |
| DOI：10.1007/s10330-016-0153-9 |
| 中文关键词: 小细胞肺癌，肿瘤退缩分级, 新辅助化疗 |
| 英文关键词: small cell lung cancer; tumor regression grading; neoadjuvant chemotherapy |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Shuonan Xu | Shaanxi Provincial People’s Hospital；Medical college of Yan'an University
The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | xsn101506@163.com | | Jianfei Zhu | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | zhujianfei718@163.com | | Yawei Dou | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | douzheng333@163.com | | Wei Tian | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | 939774621@qq.com | | Yun Dai | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | daiyun618@sina.com | | Xianghui Luo | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | luoxianghui700@sina.com | | Hongtao Wang* | Shaanxi Provincial People’s Hospital；The Third affiliated Hospital of the School of Medicine Xi'an JiaoTong University | whtsyy139@qq.com |
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| 中文摘要: |
| 目的：评估新辅助化疗在局限期小细胞肺癌治疗中的地位,明确肿瘤退缩分级在局限期小细胞肺癌中是否有可预测预后的价值。
方法：回顾性分析2000年3月1日至2014年3月31日期间在陕西省人民医院接受根治性切除的局限期小细胞肺癌患者(病理分期Ⅰ-Ⅲa)。通过Kaplan-Meier 曲线和Mantel-Cox检验，我们对比分析了A组（手术切除联合术前和术后化疗）和B组（手术切除和术后辅助化疗）的无疾病进展生存期（DFS）和总生存期（OS）。接受新辅助化疗的患者的切除病灶标本将利用肿瘤退缩分级系统（TRG）进一步进行评估。
结果：入组的27个患者的中位无疾病进展生存期为 16.267个月，中位总生存期为81.167 个月(1年生存率:74.07%;3年生存率:22.22%;5年生存率:14.81%).在本研究中，13名接受新辅助化疗的患者接受了TRG评估(病理性完全缓解率:3/13,23.08%) 。尽管两组的无疾病进展生存期无统计学差异(中位值:20.100个月 vs 14.667个月,P=0.551)，但与B组患者相比，A组患者的总生存期更长(平均值:93.782个月 vs 42.322个月,P=0.025) 。同时，统计结果显示 经TRG评估后 G0的患者的总生存期(平均值:61.222 个月) 似乎优于 G1-2的患者 (平均值:31.213个月)(P=0.311).
结论：本研究表明，对于局限期小细胞肺癌，手术联合新辅助化疗为可行有效的治疗方案，肿瘤退缩分级系统是评估新辅助化疗疗效的有价值手段，尤其对于评估为G0的患者很可能在新辅助化疗中有更好的生存获益。 |
| 英文摘要: |
| Objective The present study attempted to evaluate the value of neoadjuvant chemotherapy in limiteddisease small cell lung cancer (LD-SCLC), and to identify the predictive value of the tumor regression
grading (TRG) system in LD-SCLC treatment-response and prognosis.
Methods The records of patients with LD-SCLC (p-Stage I–IIIa) who underwent definitive radical resection at Shaanxi Provincial People’s Hospital between March 1, 2000 and March 31, 2014 were retrospectively analyzed. We compared the disease-free survival (DFS) and overall survival (OS) rates between
Group A patients (patients who underwent surgery combined with pre- and post-operative chemotherapy)
and Group B patients (patients who underwent surgery combined with adjuvant chemotherapy only) using
the Kaplan-Meier method and the Mantel-Cox test. The specimens of patients who received neoadjuvant
chemotherapy were reassessed according to the TRG system.
Results The median DFS for 27 patients was 16.267 months and the median OS was 81.167 months (1-
year OS, 74.07%; 3-year OS, 22.22%; 5-year OS, 14.81%). Thirteen patients received neoadjuvant chemotherapy, and their specimens were reassessed by TRG (pathological complete remission, 3/13, 23.08%).
Patients in group A had a longer OS than those in group B (mean, 93.782 months versus 42.322 months,
P = 0.025), although there was no significant difference in DFS between the two groups (median 20.100
months versus 14.667 months, P = 0.551). Statistical analysis revealed that TRG Grade (G) 0 (mean,
61.222 months) was associated with better OS than G1-2 (mean, 31.213 months) (P = 0.311).
Conclusion Our study indicated that neoadjuvant chemotherapy combined with surgical resection may
represent a feasible treatment method for patients with LD-SCLC. The TRG system may be a valuable prediction tool to assess neoadjuvant chemotherapeutic efficacy, especially in patients with G0 disease as determined by TRG; these patients may attain an improved survival benefit with neoadjuvant chemotherapy. |
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