| Objective: Retrospective analysis of clinical data from patients with limited stage small cell lung cancer(LS-SCLC)and analysis of the recent efficacy of radiotherapy,risk factors for brain metastasis(BM),and survival factors of SCLC was provided for clinical diagnosis and treatment.Methods: We selected 112 LS-SCLC patients who received chemotherapy in combination with radiotherapy at our hospital between February 2016 and January 2020.Survival was calculated using the Kaplan-Meier method,the Log-rank test was carefully analyzed with a single factor,and the Cox Model multifactor analysis was performed to explore risk factors associated with the development of BM and prognostic factors.Results:(1)The median age of the patients was 55 years old(48～65years old),and 42 patients(37.50%)had BM.Seventy-eight(69.64)patients in the whole group received PCI.There were 16 patients(34.04%)with BM in the sequential chemoradiotherapy(SCRT)group and 26 patients(40.00%)with BM in the concurrent chemoradiotherapy(CCRT)group.(2)Short-term efficacy evaluation: 5(4.46%)cases of complete response(CR),69 cases(61.61%)of partial response(PR),36 cases(32.14%)of stable disease(SD),and 2(1.79%)cases of Progression of Disease(PD)were achieved.There were 74 patients with CR+PR,and the response rate was 66.07%.(3)Univariate analysis: Gender(P=0.031),smoking history(P=0.003),radiation esophagitis(P=0.011)are associated with the occurrence of BM;Smoking history,ECOG(Eastern Cooperative Oncology Group)score,treatment methods,Prophylactic Cerebral Irradiation(PCI),radiation pneumonia,radiation esophagitis,and OS related factors;Gender,smoking history,radiation pneumonitis,and radiation esophagitis are associated with brain metastasis free survival(BMFS)in patients.(4)Multivariate analysis: Smoking history(P<0.001),treatment method(P=0.035),PCI(P=0.027),and radiation esophagitis(P=0.023)were independent influencing factors for OS;Smoking history(P=0.008),radiation pneumonia(P=0.043),and radiation esophagitis(P=0.003)are independent influencing factors for BMFS.(5)Survival analysis:70(62.50%)of the 112 patients in the cohort died by November 30,2022,with median progression-free survival(PFS)of 22months(12.5 to 32 months),and 1,3,and 5 year PFS rates of 80.1,24.6,and 2.7%,respectively.The median OS time was 31 months(15.5 to 42 months),and the 1 year,3year and 5 year OS rates were 80.4%,48.3% and 27.1%,respectively.The median BMFS time was 23 months(9-38 months)and the one-year,three-year and five-year BMFS rates were 78.4%,57.7% and 52.0%,respectively.Conclusion: Smoking history,treatment pattern,PCI and radioesophagitis were independent factors affecting OS.Smoking history,radiopneumonia and radioesophagitis were independent factors affecting BMFS.CCRT treatment,while it improved patient survival,did not lead to a decrease in BM.However,this is a retrospective study and these results need to be explored and validated in further prospective clinical trials. |
PDF Full Text Request