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目的小细胞肺癌根治术后巩固化疗后预防性脑照射是否能减低脑转移率，提高生存率。方法１９７８年３月～１９９４年７月收治了小细胞肺癌术后化疗后脑预防照射２５例。男１８例，女７例。术后病理分期Ⅰ，Ⅱ，ⅢＡ分别为８，８和９例。化疗方案：ＣＯＭＥ（Ｃ：环磷酰胺；Ｏ：长春新硷；Ｍ：甲氨蝶呤；Ｅ：依托泊甙），ＣＯＭＣ（Ｃ：环磷酰胺；Ｏ：长春新硷；Ｍ：甲氨蝶呤；Ｃ：卡铂），ＣＡＥ（Ｃ：环磷酰胺；Ａ：阿霉素；Ｅ：依托泊甙），ＣＥＣＡＰ（Ｃ：卡铂；Ｅ：依托泊甙；Ｃ：环磷酰胺；Ａ：阿霉素；Ｐ：顺铂）。２４Ｇｙ照射３例，３０Ｇｙ照射２２例。同期根治术后化疗后未作脑预防照射４５例作对照。结果脑转移率：预防组８％（２／２５），对照组２０％（９／４５）。预防组１，３，５年生存率分别为８８．０％，６０．０％和４７．４％。对照组分别为７３．３％，４２．２％和３４．２％。预防组Ⅰ，Ⅱ，ⅢＡ期５年生存率分别为６０．０％，５７．０％和２８．６％，对照组的分别为５７．０％，３０．８％和９．０％。结论小细胞肺癌预防性脑照射有可能减低脑转移率，提高生存率，但因病例数少不能下结论。
Objective To confirm whether prophylactic brain irradiation after chemotherapy for small cell lung cancer can reduce the rate of brain metastasis and improve survival. METHODS: From March 1978 to July 1994, 25 patients with small cell lung cancer received brain irradiation after chemotherapy. 18 males and 7 females. Postoperative pathological stage I, II, IIIA were 8, 8 and 9 cases respectively. Chemotherapy regimen: COME (C: Cyclophosphamide; O: Changchun Xinxuan; M: Methotrexate; E: Etoposide), COMC (C: Cyclophosphamide; O: Changchun Xinhao; M: Methionine) (C: cyclophosphamide; A: doxorubicin; E: etoposide), CE-CAP (C: carboplatin; E: etoposide; C: cyclophosphamide; A: doxorubicin; P: cisplatin). 24Gy irradiation in 3 cases, 30Gy irradiation in 22 cases. In the same period, 45 cases of cerebral prophylactic irradiation after radical chemotherapy were used as controls. Results Brain metastasis rate: 8% (2/25) in the prevention group and 20% (9/45) in the control group. The 1-, 3-, and 5-year survival rates in the prevention group were 88.0%, 60.0%, and 47.4%, respectively. The control group was 73.3%, 42.2% and 34.2%, respectively. The 5-year survival rates of the prophylaxis group I, II, and III A were 60.0%, 57.0%, and 28.6%, respectively, and those in the control group were 57.0%, 30.8%, and 9.0%, respectively. Conclusion Prophylactic brain irradiation for small cell lung cancer may reduce the rate of brain metastasis and increase survival rate, but it cannot be concluded because of the small number of cases.