The multimodality therapeutic result of stage III patients with small cell lung cancer

Abstract

To investigate the multimodality therapeutic result of stage III patients with small cell lung cancer. The clinical data of 89 patients with small cell lung cancer in stage III, which were treated systematically with chemotherapy or radiotherapy-operation-chemotherapy-radiotherapy from 1983 to 1993 , were analysed retrospectively and compared to those of 66 control patients with small lung cancer in stage III, which were treated with chemotherapy or/ and radiotherapy in the same period. The 1- , 3- and 5-year survival rates in the multimodality therapy group were 75. 3 %(67/ 89) , 20. 2 %(18/ 89) and 9. 0 %(8/ 89) , and in the control group they were 48. 5 %(32/ 66) , 12. 1 %(8/ 66) and 0 ( P < 0. 01) . The 1- , 3- and 5-year survival rates for stage IIIA in the multimodality group were 86. 4 %(51/ 59) , 27. 1 %(16/ 59) and 13. 6 %(8/ 59) , and were 53. 3 %(16/ 30) , 6. 7 %(2/ 30) and 0 respectively ( P < 0. 01) for stage IIIB. For stage IIIA patients , the 5-year survival rates of radical resection and palliative resectoin were 18. 4 %(7/ 38) and 4. 8 %(10/ 21) respectively ( P < 0. 01) . For stage IIIB ,whether expanded or palliative resection ,no one survived over 5 years. The 1- , 3- and 5-year survival rates were 76. 3 %(29/ 38) , 18. 4 %(7/ 38) and 2. 6 %(1/ 38) for total pneumonectomy , and 80. 9 %(38/ 47) , 23. 4 %(11/47) and 12. 8 %(6/ 47) for lobectomy. Significant difference in 5-year survival rate was found between pneumonectomy and lobectomy group ( P < 0. 05) . The clinical TNM stage is the decisive factor influencing the survival rate. Multimodality therapy could improve the survival rate obviously. Radical resection is proper for stage IIIA patients ,but for stage IIIB , whether expanded or palliative resection , the long-term survival isn't satisfactory. So we should strictly choose candidates for surgery.