肺癌致上腔静脉综合征综合治疗分析

Combined treatment of superior vena cava syndrome from lung cancer

关键词:  上腔静脉综合征  肺肿瘤  化疗  放疗

Key words:  superior vena cana syndrome  lung carcinoma  radiotherapy  chemotherapy

摘要:

［目的］探讨以冲击化疗为主后行放射治疗肺癌所致上腔静脉综合征的综合治疗临床效果。［方法］回顾分析31例肺癌致上腔静脉压迫综合征患者，先联合化疗；小细胞肺癌用CE（CBP；VP-16）或 COME（CTX；VCR；MTX；VP-16）方案、非小细胞肺癌用CAP（CTX；ADM；PDD）或 MVP（MMC；VDS；PDD）方案，配合消炎、利水、抗凝等综合治疗，症状体征缓解后开始放射治疗，总剂量DT4000~6000CGY，放疗结束3~4周再加强1个周期化疗。［结果］31例肺癌所致上腔静脉压迫综合征患者经上述治疗后完全缓解（CR）15/31（48.3%），部分缓解（PR）10/31（32.2%），无变化（NC）4/31（12.9%），进展（PD）2/31（6.4%），总有效率（CR+ PR）25/31（80.6%）。［结论］ 肺癌所致上腔静脉压迫综合征患者首先以冲击化疗为主的综合治疗措施，后行放疗对病情缓解，改善生活质量有利。

Abstract:

［Objective］ This study is an investigation of the combined treatment of superior vena cava syndrome (SVCS) from lung cancer patients. ［Methods］ Clinical data of 31 patients with SVCS from lung cancer admitted to the hospital were retrospectively analyzed. The patients had been undergone chemotherapy as follows: Patients with small cell lung cancer were treated with CE(CBP;VP-16) or COME(CTX;VCR;MTX;VP-16), while those with Non-small cell lung cancer were treated with CAP(CTX;ADM;PDD) or MVP(MMC;VDS;PDD),companied by anti-infection, anticoagulation and so on. When symptom had been relieved, radiotherapy was applied with dose arrange from 4000 to 6000 CGY. After the 3 to 4 week rest, one period of chemotherapy was used. ［Results］ In whole group , complete response (CR) was achieved in 15 patients (48.3%), partial response (PR) was found in 10 patients (32.2%), no change (NC) was seen in 4 patients (12.9%), progressive disease (PD) was observed in 2 patients (6.4%) and the overall response rate (CR+ PR) reached 80.6 %. ［Conclusion］ The combined treatment with chemotherapy followed by radiotherapy is good for patients with SVCS from lung cancer.