Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Adjuvant Chemotherapy after Surgical Resection for Small-Cell Carcinoma of Lung

소세포폐암에서 수술 후 복합화학요법의 성적

  • Kim, Hak-Ryul (Department of Internal Medicine, College of Medicine, Wonkwang University) ;
  • Jung, Jong-Hoon (Department of Internal Medicine, College of Medicine, Wonkwang University) ;
  • Kim, Hwi-Jung (Department of Internal Medicine, College of Medicine, Wonkwang University) ;
  • Yang, Sei-Hoon (Department of Internal Medicine, College of Medicine, Wonkwang University) ;
  • Jeong, Eun-Taik (Department of Internal Medicine, College of Medicine, Wonkwang University)
  • 김학렬 (원광대학교 의과대학 내과학교실) ;
  • 정종훈 (원광대학교 의과대학 내과학교실) ;
  • 김휘정 (원광대학교 의과대학 내과학교실) ;
  • 양세훈 (원광대학교 의과대학 내과학교실) ;
  • 정은택 (원광대학교 의과대학 내과학교실)
  • Received : 2004.06.10
  • Accepted : 2004.09.20
  • Published : 2004.11.30
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Abstract

Background : Small-cell carcinomas of lung have a tendency for rapid growth and early wide metastasis. Despite the high response rates of combination chemotherapy alone or with radiotherapy, the overall long-term survival rate is very disappointing. According to autopsy findings, the common cause of failure is local recurrence in the primary cancer site. Therefore, surgical resection with combined chemotherapy has recently been attempted for very early stage small-cell carcinomas of the lung. Methods : 10 patients (TNM I & II: 5 cases each) undergoing surgical resection for small-cell carcinomas of the lung were treated with adjuvant chemotherapy in an attempt to prolong survival. Of these, 9 patients received chemotherapy, and a retrospective study for survival undertaken (Kaplan-Meier analysis). Results : The median survival time was 26 months, and the 2- and 5-year survival rates were 68.6 and 46.7%, respectively. If the 1 patient not having undergone chemotherapy was excluded, the 2-, 5-year survival rates were 76.2 and 50.8%, respectively? No difference in the survival rate was seen between patients with TNM stages I and II. Conclusion : Adjuvant chemotherapy after surgical resection results in prolonged survival for patients with TNM stages I and II small-cell carcinomas of the lung.

연구배경 : 소세포폐암은 성장과 전이가 매우 빨라 치료방법으로서 외과적 절제술은 일반적으로 고려되지 않는다. 특히 화학요법의 반응율은 매우 높으나 장기 생존율은 매우 극히 낮다. 부검에 의하면 소세포폐암의 치료 실패의 원인은 원격전이보다 국소재발이 높다. 이에 저자들은 소세포폐암 중 5%정도에 그치는 TNM I, II병기의 환자들에게 수술로서 국소재발을 줄이고, 화학요법으로서 원격전이를 막고자 하는 방법을 시도하였다. 방 법 : 원광대학 병원에서 진단받은 10명의 소세포폐암 환자(TNM I병기 5례, II병기 5례)를 대상으로 수술한 후 복합 화학요법을 6회 시행한 후 생존율을 확인하였다. 결 과 : 10례 중 (관찰기간 23~179개월), 1례는 술후 폐렴으로, 1례는 화학요법 중단으로, 2례는 대뇌 재발 전이로서, 1례는 폐렴으로 사망하였고 5례는 생존중이다. 전군의 중앙 생존기간은 26개월이며 2년과 5년 생존율은 68.6%, 46.7%였으며, 술후 화학요법을 실시치 못한 1례를 제외한 9례의 2년과 5년 생존율은 76.2%, 50.8%였다. TNM I, II병기간의 생존율의 차이는 없었다. 결 론 : TNM I, II 병기의 소세포폐암 환자에서 근치적 절제술을 시행한 후 복합 화학요법을 시행하여 장기 생존율을 향상시킬수 있다고 판단된다.

Keywords

References

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