국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과

The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer

1984년 7월부터 1988년 9월까지 경북대학교병원 치료방사선과에서 소세포 폐암으로 진단되어 복합화학요법 및 방사선 병용치료를 받은 27명을 대상으로 치료성적을 분석하였다. 완전관해율은 $70\%$, 부분관해율은 $22\%$, 무반응은 $8\%$였다. 여자, 수행상태 HO, 방사선량 4500cGy이상, 화학요법 4회 이상, 그리고 혈청 enolase수치 30ng/m1 이하 등에서 완전관해율이 높게 나타났으나 통계적 의의는 없었다. 중앙생존기간은 10개월이었고 1년생존율과 2년 생존율은 각각 $40.7\%$ 및 $12.2\%$였다. 생존율을 높이는 인자로는 수험상태 HO (p<005), 완전관해 (p<0.05), 하학요법 4회 이상(p<005), 방사선량 4500 cGy이상 등으로 나타났으며, 성별과 예방적 전뇌조사는 영향을 미치지 않았다.

From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality (combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19$(70\%)$ achieved a complete response, 6$(22\%)$ a partial response, and 2$(8\%)$ no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 months and overall 1- and 2-year survival rates were $40,7\%$ and $12.2\%$, respectively. Complete response (p<0.05), performance status HO (p<0.05), 4 or more cycles of chemotherapy (p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage.