Comparative Study Of Concurrent Chemoradiotherapy And Sequential Chemoradiotherapy For Limited Stage Small Cell Lung Cancer

Objective: The purpose of this study is to retrospectively observe and analyze the effects of concurrent chemoradiotherapy and sequential chemoradiotherapy on the efficacy,survival rate and adverse reactions of patients,and to further explore the therapeutic effect of concurrent chemoradiotherapy and sequential chemoradiotherapy on locally limited small cell lung cancer.Methods: The study included 42 patients with limited small cell lung cancer diagnosed in the Department of oncology of Handan Central Hospital from January 2012 to December 2018.According to different treatment methods,they were divided into concurrent chemoradiotherapy group and sequential chemoradiotherapy group.The concurrent group received chemotherapy and radiotherapy at the same time and standard chemotherapy regimen EP(etoposide + platinum),while the sequential chemoradiotherapy group received chemotherapy first and then radiotherapy,or radiotherapy first and then chemotherapy.Chi square test was used for correlation analysis,Kaplan Meier method was used for survival curve drawing,log rank test was used for univariate survival analysis,Cox risk regression model was used for multivariate survival analysis,P < 0.05 was considered to be statistically significant.Results: compared with the sequential group,the progression free survival(PFS)and overall survival(OS)were significantly prolonged in the synchronous group.The median PFS was 11.8 months vs 8.8 months,P = 0.033,and the median OS was 28.9 months vs 20.2 months,P =0.035.In the synchronous group,the MPFs and MOS of the early intervention group(early radiotherapy: ≤ 2 cycles plus radiotherapy)were significantly longer than those of the late intervention group(late radiotherapy: > 2 cycles plus radiotherapy)(13.5 months vs 8.9 months,30.7 months vs 19.4 months,P < 0.05).In univariate analysis,the results showed that female patients had significantly higher OS than male patients(32.8 months vs 19.9 months,P = 0.014);the OS of non-smoking patients was significantly longer than that of smoking patients(32.9months vs 20.2 months,P = 0.028);the OS of patients younger than 60 years was longer than that of patients older than 60 years(26.8 months vs20.2 months,P = 0.028)5 months),P = 0.039,the three results were statistically significant,which showed that gender,age and smoking status were related factors affecting OS.In multivariate analysis,the results showed that age and treatment mode were related to OS,P = 0.037 and 0.019,HR = 0.739 and 0.434,respectively,indicating that age and treatment mode were independent factors affecting OS.Conclusion: 1.Compared with sequential chemoradiotherapy,concurrent chemoradiotherapy can better improve the PFS and OS of patients,and improve the 1-year,2-year and 3-year survival rate of patients,with controllable adverse reactions.2.The earlier the time of chest radiotherapy(≤ 2 cycles),the better the long-term prognosis of patients.3.Age,gender and smoking status were the influencing factors of OS,but age and treatment mode were the independent factors.