The Study On The Clinical Features Of Patients With Small Cell Lung Cancer And The Correlation Between Therapeutic Effect

Objective: At present, the morbidity and mortality of cancer is risingyear by year in which, lung cancer is ranked in the forefront. Now reportsshowed that the morbidity and mortality of lung cancer is in the first place ofmalignant tumor，small cell lung cancer (SCLC) accounted for12%~15%ofthe total number of lung cancer, the malignant degree is high, prone to distantmetastasis and recurrence easily. More than70%of patients diagnosed withSCLC have had mediastinal lymph node metastasis, about60%of patientswith distant metastasis. According to a literature reports although80%~90%patients of limited stage and about70%patients of the extensive stage acceptcytotoxic drugs chemotherapy after tumor can be alleviated, but usuallyremission can not last for a long time (median time to remission as much as6to8months), and as much as95%of patients will eventually die from diseaserecurrence or metastasis. Therefore, looking for longer small cell lung canceras first-line treatment of progression free survival (PFS) become the focus ofattention, this study will start from the clinical features of SCLC patients, theradiation time, serum sodium and serum tumor markers and so on toinvestigate the prognostic factors and to provide better the basis for theimprovement of survival and prognosis in patients with small cell lung cancer.Methods: The52cases of lung cancer patients were collected that werehospitalized in the respiratory department of fourth hospital of Hebei medicaluniversity from February2006to April2013. All of the patients are identifiedas lung cancer by the histopathological and/or cell pathological. All patientseliminated extra pulmonary primary tumor and genetic disease history.According to the requirements, we record the clinical information for allpatients, including gender, age, smoking status, clinical staging, serum sodium,neural specificity enolization enzyme treatment and efficacy.52patients with SCLC follow-up, calculated on a month of first-line treatmentprogression-free surial (PFS), and analyzed with the clinical features, therelationship between serum sodium, NSE and radiation time. The Mann-Whitney U nonparametric rank and inspection is a first-line treatment inpatients with different clinical features of PFS difference, P <0.05, said thedifference was statistically significant.Results：1In this study,39cases of male patients, accounted for75%,13case offemale patients, accounted for25%;<60years old in29cases, accounted for55.8%,23patients with60or older, accounted for about44.2%,;30cases ofsmokers accounted for57.7%,22cases of nonsmokers, accounted for about42.3%;25patients with limit stage, accounted for48.1%,27patients withextensive stage, accounted for51.2%.In the study,17cases of patients with serum sodium <135mmol/laccounted for about44.7%,21cases of patients with normal serum sodium,accounted for about55.3%.In this study, NSE>16.3ng/ml in36cases, accounted for97.3%,<16.3ng/ml in1case, accounted for0.7%; the maximum value of NSE is370ng/ml, the lowest NSE value is2.13ng/ml, average value95ng/ml. In37patients, NSE<95ng/ml in28cases, accounted for75.7%,>95ng/ml in9cases,accounted for24.3%; after the2cycle of chemotherapy return to normal in15cases, accounted for60%,10cases of NSE is>16.3ng/ml, accounted for40%.Three cycles of chemotherapy to radiotherapy is defined as earlyradiotherapy, a total of10cases (58.8%), and chemotherapy cycle after threecycles and3radiations is defined as late radiation, a total of7cases,accounting for41.2%.2In all small cell lung cancer patients, male patients with39cases,including a PFS for7months,13cases of female patients, including a PFS for10months, the comparison between two groups, P=0.022;29cases of patientswith <60years old, including a PFS for8months;23cases of patientswith≥60years old, including a PFS for9months, P=0.322;30cases of smokers, including a PFS for7months;22cases of nonsmokers, including aPFS for9.5months, P=0.163;25cases of patients with limited stage,including a PFS for9months,27patients with extensive stage, including aPFS for7months, the comparison between two groups, P=0.037.328cases of patients with <95ng/ml, including a PFS for9months,10cases of patients with NSE≥95ng/ml, including a PFS for5months, P=0.014,comparison between the two groups was statistically significantdifference.After2cycles of chemotherapy,15cases of patients with NSE restorednormal, including a PFS for10months;10cases of patients with NSE stillhigher including a PFS for8.5months, P=0.179,comparison between the twogroups was no statistically significant difference.17cases of patients with serum sodium <135mmol/l, including a PFS for7months,21cases of patients with normal serum sodium, including a PFS is8months, P=0.340. comparison between the two groups was no statisticallysignificant difference.410cases of early radiotherapy group, the median PFS was10months;7cases of late radiation therapy, the median PFS was9months. P=0.163,P>0.05, the comparison between two groups was no significant difference.Conclusions：1his study shows that age, smoking status, sodium levels beforetreatment with PFS of first-line treatment of small cell lung cancer isindependent.2NSE levels before treatment with PFS of first-line treatment of smallcell lung cancer-related, NSE＜95ng/ml (median PFS was10months) issignificantly longer than NSE≥95ng/ml (median PFS was5months).3Sex is predictor of PFS the first-line treatment of SCLCpatients female patients (median PFS was10months) is significantly longerthan male patients (median PFS was7months).4Clinical stages is a predictor of SCLC patients treated first-line PFS, forlimited stage (median PFS was10months) was significantly longer than extensive stage (median PFS was7months).5The PFS of early radiotherapy has a tendency to extend comparing thePFS of late radiotherapy.