Treatment Outcomes of Primary Pulmonary Lymphoepithelioma-like Carcinoma: a Series of 22 Patients and Treatment Strategy Review
FST Mok, OSH Chan, ATY Chang, LLK Chan, IS Soong, WT Ng, FY Cheung, RMW Yeung
Hong Kong J Radiol 2013;16:270-7
DOI: 10.12809/hkjr1313176
Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subgroup of non–small-cell lung cancer. Limited published series suggested that it might be associated with more favourable survival than ordinary non–small-cell lung cancer. We set out to review the treatment outcomes of patients with primary pulmonary LELC treated in our institution since 1994.
Methods: All patients with pathologically confirmed primary pulmonary LELC treated between 1994 and 2012 were retrospectively reviewed. Treatment modalities and outcomes — including local control rate, disease-free and overall survival — were analysed.
Results: Twenty-two patients with primary pulmonary LELC were identified. Their median follow-up duration was 33 months (range, 1 day to 106 months). Surgery was the mainstay of treatment for patients with stage I to II diseases. Those with advanced non-metastatic disease (n = 5) treated with high-dose radiotherapy (EQD2 60 Gy) with or without platinum-based chemotherapy had a local control rate of 100% after a median follow-up of 68 months. The 5-year progression-free survival (PFS) and overall survival (OS) were 53% and 80%, respectively. Their median PFS and OS had not reached at the time of publication. For patients with stages III and IV disease beyond radical radiotherapy portals, palliative platinum doublets gave a median disease-free survival of 10 months in 12 patients. The 5-year OS of stage I-II, III, and IV patients were 41%, 38%, and 25%, respectively (p = 0.61). Their median OS durations were 58, 30, and 19 months, respectively.
Conclusion: Our series echoed prior suggestions that primary pulmonary LELC achieves favourable outcomes.
中文摘要
原發性肺淋巴上皮瘤樣癌的治療效果：22個病例以及其治療策略回顧
莫小婷、陳少康、張天怡、陳麗君、宋崧、吳偉棠、張寬耀、楊美雲
目的：原發性肺淋巴上皮瘤樣癌（LELC）是非小細胞肺癌的一種罕見亞型。一系列有限的文獻提示原發性肺淋巴上皮瘤樣癌可能會比一般非小細胞肺癌的生存率高。本文回顧自1994年以來，於我們醫院診治的原發性肺LELC患者的治療效果。
方法：回顧性分析所有1994至2012年期間經病理學證實的原發性肺LELC的患者紀錄。分析治療方式和結果，包括局部控制率、無病生存率和總體生存率。
結果：發現原發性肺LELC22例。病例的隨訪期中位數為33個月（範圍：1日至106個月）。對於第I至第II期的患者來說，手術是主要的治療方法。於中位隨訪期68個月後，接受高劑量放療（EQD2為60 Gy）的晚期無轉移瘤患者（n = 5）局部控制率達100%；伴或不伴以鉑類藥物為基礎的化療均如此。五年無進展生存率（PFS）和總體生存率（OS）分別為53%和80%。至本文發表時，尚未獲得PFS和OS的中位數數據。至於無法施以根治性放療第III及第IV期患者，有12例因接受含鉑類雙藥聯合方案的姑息性化療而無瘤中位生存期達至10個月。第I-II、III和IV期的五年OS分別為41%、38%和25%（p = 0.61），其中位生存期分別為58、30和19個月。
結論：本系列研究結論呼應之前的報道，即原發性肺LELC的治療效果是樂觀的。