Table CDR62945 Small Cell Lung Cancer Treatment/小细胞肺癌治疗
ID Type Description_en Description_zh
w1 Word Survival 生存率
w2 Word Anorexia 食欲下降
w3 Word Hoarseness 声嘶
w4 Word Topotecan 拓扑替康
w5 Word Paclitaxel 紫杉醇
w6 Word Other regimens 其他方案
w7 Word Standard treatment 标准治疗
w8 Word Extensive-Stage Disease 广泛期
w9 Word Recurrent disease 复发
w10 Word Palliative therapy 姑息治疗
w11 Word Evidence (topotecan): 证据（拓扑替康）：
w12 Word Ill-defined borders 边界不清
w13 Word limited-stage SCLC 局限期SCLC
w14 Word Combination chemotherapy 联合化疗
w15 Word Staging Systems 分期系统
w16 Word Neurologic sequelae 神经后遗症
w17 Word Deaths: 159,260 死亡病例：159,260例
w18 Word Pathologic Classification 病理学分类
w19 Word extensive-stage SCLC 广泛期SCLC
w20 Word Chest pain 胸痛
w21 Word Performance status 身体状况评分
w22 Word Scant cytoplasm 胞浆少
w23 Word Chest x-ray 胸片
w24 Word Cellular classification--legacy 细胞学分类—legacy
w25 Word Evidence (PCI): 证据（PCI）：
w26 Word Stage explanation--legacy 分期说明—legacy
w27 Word Limited-Stage Disease 局限期
p1 Phrase Etoposide + cisplatin 依托泊苷+顺铂
p2 Phrase Cisplatin + irinotecan 顺铂+伊立替康
p3 Phrase Prophylactic cranial irradiation 预防性脑照射
p4 Phrase Lambert-Eaton myasthenic syndrome Lambert-Eaton肌无力综合征
p5 Phrase New cases: 224,210 新发病例：224,210例
p6 Phrase New drug regimens 新药方案
p7 Phrase Frequent nuclear molding 常见核铸型
p8 Phrase Etoposide + carboplatin 依托泊苷+卡铂
p9 Phrase Intermediate-grade atypical carcinoid 中等分级不典型类癌
p10 Phrase Paraneoplastic cerebellar degeneration 副肿瘤性小脑变性
p11 Phrase Combination chemotherapy alone 单独联合化疗
p12 Phrase Dose and timing 剂量与时间
p13 Phrase Evidence (standard regimens): 证据（标准方案）：
p14 Phrase Low-grade typical carcinoid 低分级典型类癌
p15 Phrase Length of treatment 治疗持续时间
p16 Phrase Evidence (combined modality treatment): 证据（综合治疗）：
p17 Phrase Inappropriate antidiuretic hormone secretion 抗利尿激素分泌失调
p18 Phrase Absent or inconspicuous nucleoli 核仁缺失或不明显
p19 Phrase Chemotherapy and radiation therapy 化疗联合放疗
p20 Phrase A high mitotic count 核分裂象增多
p21 Phrase A thorough physical examination 全面的体格检查
p22 Phrase Evidence (role of PCI): 证据（PCI的作用）：
p23 Phrase Prophylactic cranial irradiation (PCI) 预防性脑照射（PCI）
p24 Phrase Evidence (role of surgery): 证据（手术的作用）：
p25 Phrase A radionuclide bone scan 放射性核素骨显像
p26 Phrase small cell lung cancer 小细胞肺癌
p27 Phrase IASLC-AJCC TNM Staging System IASLC-AJCC TNM分期系统
p28 Phrase Cyclophosphamide + doxorubicin + vincristine 环磷酰胺+阿霉素+长春新碱
p29 Phrase Treatment Options Under Clinical Evaluation 处于临床评估阶段的治疗方法
p30 Phrase Factors influencing treatment with chemotherapy 影响化疗的因素
p31 Phrase Treatment options for recurrent cancer 癌症复发的治疗方法
p32 Phrase Combination chemotherapy and radiation therapy 联合化疗与放疗
p33 Phrase Alternative drug doses and schedules 变换药物剂量与方案
p34 Phrase Cyclophosphamide + doxorubicin + etoposide 环磷酰胺+阿霉素+依托泊苷
p35 Phrase Treatment options for older patients 老年患者的治疗选择
p36 Phrase Ifosfamide + cisplatin + etoposide 异环磷酰胺+顺铂+依托泊苷
p37 Phrase Neuroendocrine tumors include the following: 神经内分泌肿瘤包括：
p38 Phrase Cyclophosphamide + etoposide + vincristine 环磷酰胺+依托泊苷+长春新碱
p39 Phrase recurrent small cell lung cancer 小细胞肺癌复发
p40 Phrase Evidence (other combination chemotherapy regimens): 证据（其他联合化疗方案）：
p41 Phrase Surgical resection of the primary tumor 原发肿瘤手术切除
p42 Phrase Surgery followed by chemotherapy or chemoradiotherapy 手术后化疗或放化疗
p43 Phrase Recurrent Small Cell Lung Cancer Treatment 小细胞肺癌复发的治疗
p44 Phrase Finely granular "salt and pepper" chromatin 染色质呈细颗粒状“盐和胡椒”样
p45 Phrase Small Cell Lung Cancer (PDQ®): Treatment 小细胞肺癌（PDQ®）：治疗
p46 Phrase These studies have yielded conflicting results 这些研究结果并不一致
p47 Phrase Limited-Stage Small Cell Lung Cancer Treatment 局限期小细胞肺癌的治疗
p48 Phrase limited stage small cell lung cancer 局限期小细胞肺癌
p49 Phrase extensive stage small cell lung cancer 广泛期小细胞肺癌
p50 Phrase Veterans Administration Lung Study Group (VALG) 退伍军人管理局肺癌研究组（VALG）分期系统
p51 Phrase Routine blood counts and serum chemistries 血常规与生化
p52 Phrase Standard staging procedures include the following: 标准分期程序包括：
p53 Phrase Extensive-Stage Small Cell Lung Cancer Treatment 广泛期小细胞肺癌的治疗
p54 Phrase Cushing syndrome from secretion of adrenocorticotropic hormone 促肾上腺皮质激素分泌过量引起库欣综合征
p55 Phrase Surgery followed by chemotherapy or chemoradiation therapy 手术加化疗或放化疗
p56 Phrase Stage Information for Small Cell Lung Cancer 分期评估
p57 Phrase and offers palliation of symptomatic metastatic disease 且可能缓解肿瘤转移产生的症状
p58 Phrase General Information About Small Cell Lung Cancer 小细胞肺癌（NSCLC）的基本信息
p59 Phrase Cellular Classification of Small Cell Lung Cancer 小细胞肺癌的细胞分类
p60 Phrase Topotecan is standard chemotherapy for recurrent SCLC 拓扑替康是SCLC复发后的标准化疗
s1 Sentence Confirmed response rates were 18.3% and 21.9%, respectively 两组的缓解率分别为18.3%与21.9%
s2 Sentence Treatment Option Overview for Small Cell Lung Cancer 小细胞肺癌的治疗方法概述
s3 Sentence Treatment-related deaths were comparable between the two groups 两种方案的治疗相关死亡率相似
s4 Sentence Brain metastases are treated with whole-brain radiation therapy 脑转移使用全脑照射治疗
s5 Sentence Chest and upper abdominal computed tomography (CT) scanning 胸部与上腹部CT
s6 Sentence Other studies have tested intensive one-drug or two-drug regimens 一些其他研究评估了强化的单药治疗与两药治疗方案
s7 Sentence International Association for the Study of Lung Cancer (IASLC) 国际肺癌研究会（IASLC）分期系统
s8 Sentence The optimal dose and timing of TRT remain controversial 胸部放疗（TRT）的最优剂量与治疗时间仍无一致结论
s9 Sentence No consistent survival benefit has resulted from the following 研究中改变下列指标后并无一致的生存获益
s10 Sentence The optimal therapeutic approach in older patients remains unclear 针对老年患者的最佳治疗方式尚不明确
s11 Sentence A brain magnetic resonance imaging scan or CT scan 脑磁共振成像或CT
s12 Sentence These patients are designated as having limited-stage disease (LD) 这些患者的疾病为局限期疾病（LD）
s13 Sentence These patients have the greatest benefit from second-line chemotherapy 这些患者经二线治疗获益最大
s14 Sentence The lead reviewers for Small Cell Lung Cancer Treatment are: 小细胞肺癌治疗的主要审核人包括：
s15 Sentence High-grade neuroendocrine tumors including large-cell neuroendocrine carcinoma (LCNEC) and SCLC 高分级神经内分泌肿瘤，包括大细胞神经内分泌肿瘤（LCNEC）与SCLC
s16 Sentence Table 2. Combination Chemotherapy For Extensive-Stage Small Cell Lung Cancer 表2. 广泛期小细胞肺癌的联合化疗
s17 Sentence The overall survival at 5 years is 5% to 10% 总体5年生存率为5%-10%
s18 Sentence The current classification of subtypes of SCLC includes the following: 当前的SCLC亚分类包括：
s19 Sentence The role of positron emission tomography (PET) is still under study 化疗提高局限期（LD）或广泛期（ED）患者的生存，但仅有少数患者可治愈
s20 Sentence Standard treatment options for patients with extensive-stage SCLC include the following: 广泛期SCLC患者的标准治疗方法包括：
s21 Sentence Adding TRT increases absolute survival by approximately 5% over chemotherapy alone TRT联合化疗与单独化疗相比，生存率绝对增加约5%
s22 Sentence American Joint Committee on Cancer (AJCC) Tumor, Node, and Metastasis (TNM) 美国癌症联合委员会（AJCC）肿瘤、淋巴结、转移（TNM）分期
s23 Sentence Expert-reviewed information summary about the treatment of small cell lung cancer 关于小细胞肺癌治疗的专家审核信息总结
s24 Sentence Standard treatment options for patients with limited-stage SCLC include the following: 局限期SCLC患者的标准治疗选择包括：
s25 Sentence Patients with LD have a better prognosis than patients with ED 局限期患者预后好于广泛期患者
s26 Sentence SCLC associated with LCNEC is diagnosed as SCLC combined with LCNEC SCLC与LCNEC成分混合的诊断为混合LCNEC的SCLC
s27 Sentence An important prognostic factor for SCLC is the extent of disease SCLC的一个重要预后因素是肿瘤侵犯范围
s28 Sentence The role of dose intensification in patients with SCLC remains unclear 剂量强化对SCLC患者的作用尚不明确
s29 Sentence Response to first-line chemotherapy predicts for subsequent response to second-line therapy 对一线化疗的反应能够预测对后续二线治疗的反应
s30 Sentence Patients with distant metastases (M1) are always considered to have ED 远处转移（M1）均被视为广泛期
s31 Sentence Standard treatment options for patients with recurrent SCLC include the following: SCLC复发后标准治疗方法包括：
s32 Sentence (Refer to the PDQ summary on Cardiopulmonary Syndromes for more information.) （更多信息请参考PDQ总结心肺综合征）
s33 Sentence The 3-year OS was improved from 15% to 21% with PCI PCI使得3年总生存率从15%提高到21%
s34 Sentence Standard Treatment Options for Patients With Extensive-Stage Small Cell Lung Cancer (SCLC) 广泛期小细胞肺癌（SCLC）患者的标准治疗方法
s35 Sentence Standard Treatment Options for Patients With Limited-Stage Small Cell Lung Cancer (SCLC) 局限期小细胞肺癌（SCLC）患者的标准治疗选择
s36 Sentence Standard Treatment Options for Patients With Recurrent Small Cell Lung Cancer (SCLC) 小细胞肺癌（SCLC）复发患者的治疗方法
s37 Sentence Small cell lung cancer (SCLC) accounts for approximately 15% of bronchogenic carcinomas 小细胞肺癌（SCLC）占支气管来源癌症的约15%
s38 Sentence Table 1. Standard Treatment Options for Patients With Small Cell Lung Cancer 表1. 小细胞肺癌患者的标准治疗选择
s39 Sentence PET was more sensitive and specific than CT scans for nonbrain distant metastases PET对非脑远处转移的敏感性和特异性均高于CT
s40 Sentence Treatment options under clinical evaluation for patients with LD SCLC include the following: 处于临床评估阶段的局限期 SCLC患者的治疗方法包括：
s41 Sentence Patients with a contraindication to radiation therapy could be treated with chemotherapy alone 有放疗禁忌证的患者可仅接受化疗
s42 Sentence SCLC is fluorodeoxyglucose (FDG) avid at the primary site and at metastatic sites 因SCLC患者发生远处转移的风险较大，局部治疗例如手术切除或放疗也很少让患者有长期生存
s43 Sentence The older patients experienced more toxic effects, particularly hematologic, compared with younger patients 但与年轻患者相比，老年患者的毒性反应发生率较高，尤其是血液学毒性反应
s44 Sentence Only the rare patient, however, will experience long-term survival following salvage radiation therapy 仅有极少数患者在挽救性放疗后可长期生存
s45 Sentence SCLC presents as a proliferation of small cells with the following morphological features: SCLC中增生的小细胞具有下列形态学特点：
s46 Sentence Combined small cell carcinoma (i.e., SCLC combined with neoplastic squamous and/or glandular components) 混合型小细胞癌（即SCLC与鳞癌和（或）腺癌的混合型）
s47 Sentence Treatment options under clinical evaluation for patients with ED SCLC include the following: 处于临床评估阶段的广泛期 SCLC患者的治疗方法包括：
s48 Sentence The role of surgery in the management of patients with SCLC is unproven 手术对治疗SCLC患者的作用尚未肯定
s49 Sentence Improved long-term survival in patients with LD has been shown with combined-modality therapy 研究显示局限期患者经综合治疗可提高长期生存率
s50 Sentence Single-agent intravenous, oral, and low-dose biweekly regimens have been developed for these patients 对这些患者目前已有静脉用或口服单药治疗及低剂量每2周一次的治疗方案
s51 Sentence Treatment for patients with limited-stage, extensive-stage, or recurrent SCLC is summarized in Table 1 局限期、广泛期或复发SCLC患者的治疗总结见表1
s52 Sentence New radiation therapy schedules and techniques (e.g., timing, three-dimensional treatment planning, and dose fractionation) 新放疗方案与技术（例如，治疗时机，三维治疗计划与剂量分割）
s53 Sentence The most common symptoms at presentation are worsening cough, shortness of breath, and dyspnea 发病时最常见的症状为咳嗽加重、呼吸短促与呼吸困难
s54 Sentence Two meta-analyses evaluating the role of platinum combinations versus nonplatinum combinations have been published 有2项对比评估铂类联合化疗与非铂类联合化疗的荟萃分析已经发表
s55 Sentence The combination of platinum and etoposide is the most widely used standard chemotherapeutic regimen 铂类联合依托泊苷是最常用的标准化疗
s56 Sentence At the time of recurrence, many SCLC patients are potential candidates for further therapy 很多SCLC患者在复发时仍可接受进一步治疗
s57 Sentence Esophagitis was increased with twice-daily treatment. Twice-daily radiation therapy has not been broadly adopted 每日两次照射后食管炎发生率增加，目前尚未广泛采纳每日两次照射
s58 Sentence Such patients have a poor prognosis and tolerate aggressive chemotherapy or combined-modality therapy poorly 这些患者预后较差，对积极化疗或综合治疗的耐受性也较差
s59 Sentence Only one of the trials showed the superiority of the irinotecan and cisplatin combination 其中仅有1项试验显示伊立替康联合顺铂的优效性
s60 Sentence Patients who have achieved a complete remission can be considered for administration of PCI 达到完全缓解的患者可考虑接受PCI
s61 Sentence Older patients were also less likely to respond to therapy and had poorer survival outcomes 老年患者经治疗后缓解几率更小，而生存预后通常更差
s62 Sentence Nearly all SCLC are immunoreactive for keratin, thyroid transcription factor 1, and epithelial membrane antigen 几乎所有的SCLC均对角蛋白、甲状腺转录因子1和上皮膜抗原有免疫反应
s63 Sentence No consistent survival benefit has resulted from the addition of paclitaxel to etoposide and cisplatin 在依托泊苷联合顺铂方案中加入紫杉醇不增加生存获益
s64 Sentence This corresponded to an increase of 9% in 1-year OS and 4% in 2-year OS 相当于1年OS增加9%，2年OS增加4%
s65 Sentence One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC 约75%的SCLC中可见至少一种神经内分泌分化标志物的表达
s66 Sentence The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 还可以根据部位、药物、干预方法或其他标准进行筛选
s67 Sentence The median survival was 11.8 months in the cisplatin arm and 12.5 months in carboplatin-treated patients 顺铂组与卡铂组的中位生存时间分别为11.8月与12.5月
s68 Sentence The survival outcomes for the older patients were identical to their younger counterparts in both trials 两项研究均发现老年患者的生存结果与年轻患者相同
s69 Sentence Early studies showed that under-treatment compromised outcome and suggested that early dose intensification may improve survival 早期研究显示治疗剂量不足影响患者预后，早期剂量强化可能改善预后
s70 Sentence The majority of patients treated with radiation therapy obtain objective responses and improvement following radiation therapy 绝大多数放疗患者在放疗后达到客观缓解
s71 Sentence Quality-of-life (QOL) analysis (using a nonvalidated QOL questionnaire) demonstrated no significant difference between the two arms 生活质量（QOL）分析（使用未经验证的QOL问卷评估）显示两组的QOL无显著差异
s72 Sentence Sensitive patients have a first-line response that lasted more than 90 days after treatment was completed 敏感患者一线治疗后从治疗完成开始计算的缓解时间大于90天
s73 Sentence Intracranial metastases from small cell carcinoma may respond to chemotherapy as readily as metastases in other organs 小细胞肺癌的颅内转移灶对化疗的反应可能与其他器官转移一样好
s74 Sentence Unsuspected nodal metastases were documented in 25% of patients, which altered the radiation plan in these patients 25%患者新发现此前未检查出的淋巴结转移，从而更改放疗方案
s75 Sentence Patients with tumors that have spread beyond the supraclavicular areas are said to have extensive-stage disease (ED) 肿瘤扩散至超过锁骨上区域称为广泛期疾病（ED）
s76 Sentence Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 3) 更新2014年新发病例与死亡病例的统计学数据（引用美国癌症协会参考文献3）
s77 Sentence Bone marrow aspirate or biopsy in selected patients in which treatment would change based on the results 如果骨髓情况可能影响治疗，则这部分患者需行骨髓穿刺或活检
s78 Sentence Older patients were less likely to be treated with combined chemoradiation therapy, more intensive chemotherapy, and PCI 老年患者接受联合放化疗、强化化疗与PCI的可能性较小
s79 Sentence A population analysis showed that increasing age was associated with a decreased performance status and increased comorbidity 一项人群分析显示年龄增加与身体状评分下降、合并症增多相关
s80 Sentence SCLC arising from neuroendocrine cells forms one extreme of the spectrum of neuroendocrine carcinomas of the lung 神经内分泌细胞来源的SCLC，是特殊的肺神经内分泌癌
s81 Sentence The Hellenic Oncology Group conducted a phase III trial comparing cisplatin and etoposide with carboplatin plus etoposide Hellenic肿瘤组进行了一项III期临床试验，比较了顺铂联合依托泊苷与卡铂联合依托泊苷的作用
s82 Sentence Whether this was a result of age and its associated comorbidities or suboptimal treatment delivery remains uncertain 但该现象与年龄相关，还是与年龄相关的合并症或次优治疗相关尚不明确
s83 Sentence SCLC is highly radiosensitive and thoracic radiation therapy improves survival of patients with LD and ED tumors SCLC具有高度放疗敏感性，胸部放疗改善局限期与广泛期患者的生存
s84 Sentence Subsequent trials and the meta-analyses support that the regimens provide equivalent clinical benefit with differing toxicity profiles 后续试验及荟萃分析显示这两种方案的临床获益相似，但毒性反应则不同
s85 Sentence Infrequently, patients with SCLC may present with symptoms and signs of one of the following paraneoplastic syndromes: 少数患者可能出现副肿瘤疾病症状与体征：
s86 Sentence Five trials and two meta-analyses have evaluated the combination of etoposide and cisplatin versus irinotecan and cisplatin 5项临床试验与2项荟萃分析比较了依托泊苷联合顺铂与伊立替康联合顺铂的作用
s87 Sentence Chemotherapy and radiation therapy have been shown to improve survival for patients with small cell lung cancer (SCLC) 研究发现化疗与放疗改善小细胞肺癌（SCLC）患者的生存
s88 Sentence A number of clinical trials have examined the use of colony-stimulating factors to support dose-intensified chemotherapy in SCLC 很多临床试验评估了集落刺激因子增强SCLC中剂量强化化疗的作用
s89 Sentence Several staging systems have been proposed for small cell lung cancer (SCLC). These staging systems include the following: 小细胞肺癌（SCLC）有多种不同的分期系统，包括：
s90 Sentence In a small series of 24 patients with LD by conventional staging, two patients were upstaged to ED 一项小规模病例分析发现用传统方法分期的24例局限期患者中，2例患者分期上调至广泛期
s91 Sentence The risk of developing CNS metastases can be reduced by more than 50% by the administration of PCI PCI可使CNS转移的风险降低超过50%
s92 Sentence No clear evidence is available from reported data from randomized trials that maintenance chemotherapy will improve survival duration 来自临床试验的数据中无明确证据证实维持化疗改善生存时间
s93 Sentence Even these patients, however, are at risk of dying from lung cancer (both small and non-small cell types) 即使是这部分患者仍有死于肺癌死亡风险（小细胞肺癌与非小细胞肺癌均为如此）
s94 Sentence Investigations of patients with suspected SCLC focus on confirming the diagnosis and determining the extent of the disease 对怀疑SCLC的患者，检查的主要目的是确诊、判断病变受累范围
s95 Sentence Patients with ED treated with chemotherapy who have achieved a response can be considered for administration of PCI 广泛期患者如化疗后缓解，可考虑行PCI
s96 Sentence In patients who receive chemotherapy with radiation therapy, there is no improvement in survival with the addition of surgery 对于已经接受了放化疗的患者手术不增加生存获益
s97 Sentence Combined small cell carcinoma includes a mixture of small cell and large cell or any other non-small cell component 混合型小细胞癌包括小细胞与大细胞混合型或小细胞与其他任何非小细胞成分混合型
s98 Sentence The study enrolled 141 patients with chemosensitive or chemoresistant relapsed SCLC who were unsuitable for further standard intravenous chemotherapy 该研究共纳入141例化疗敏感或化疗耐药的SCLC复发患者，且这些患者不适于继续接受标准的静脉化疗
s99 Sentence The amount of time from start to completion of TRT in LD SCLC may also effect overall survival (OS) 局限期 SCLC患者从开始胸部放疗到完成的时间也可能影响总生存（OS）
s100 Sentence About 80% of older patients, however, received optimal treatment, and their survival was comparable to that of younger patients 有80%的老年患者接受优化治疗，其生存获益与年轻患者相似
s101 Sentence Carboplatin is active in SCLC, is dosed according to renal function, and is associated with less nonhematological toxic effects 卡铂也是SCLC治疗常用药物，需根据肾功能决定剂量，非血液学毒性反应较少
s102 Sentence Patients with central nervous system (CNS) recurrences can often obtain palliation of symptoms with additional chemotherapy and/or radiation therapy 有中枢神经系统（CNS）复发的患者通常加用化疗和（或）放疗可缓解症状
s103 Sentence The overall incidence and mortality rates of SCLC in the United States have decreased during the past few decades 在过去数十年内，在美国SCLC的总发病率与死亡率有所下降
s104 Sentence More patients with ED SCLC have greatly impaired performance status at the time of diagnosis than patients with LD 广泛期 SCLC患者中诊断时身体状况评分较差的患者比例大于局限期患者
s105 Sentence Patients with sensitive disease may achieve response to a number of agents including topotecan, irinotecan, taxanes, vinorelbine, paclitaxel, or gemcitabine 敏感性肿瘤患者可能对很多药物有良好反应，包括拓扑替康、伊立替康、紫杉烷、长春瑞滨、紫杉醇或吉西他滨等
s106 Sentence Staging procedures for SCLC are important in distinguishing patients with disease limited to their thorax from those with distant metastases SCLC分期对区分病变局限于胸腔和有远处转移有重要作用
s107 Sentence Other regimens appear to produce similar survival outcomes but have been studied less extensively or are in less common use 其他方案似乎能达到相似的生存结果，但相关研究及应用均较少
s108 Sentence Patients who have undergone surgery and then been diagnosed with SCLC generally receive adjuvant chemotherapy with or without radiation therapy 先经手术然后才确认的SCLC患者通常接受辅助化疗，伴或不伴放疗
s109 Sentence Cisplatin is associated with significant toxic effects and requires fluid hydration, which can be problematic in patients with cardiovascular disease 顺铂具有明显毒性反应，需水化，水化对于心血管疾病的患者而言较为困难
s110 Sentence If ED is confirmed, further evaluation should be individualized according to the signs and symptoms unique to the individual patient 如果确诊广泛期，应根据患者特有的症状体征进行个体化评估
s111 Sentence Treatment options under clinical evaluation for patients with recurrent SCLC include phase I and II clinical trials of new drugs 处于临床评估阶段的SCLC复发患者的治疗方法包括新药I、II期临床试验
s112 Sentence The preponderance of evidence available from randomized trials indicates that maintenance chemotherapy does not prolong survival for patients with LD SCLC 来自随机临床试验的大量证据表明维持化疗不延长局限期患者的生存时间
s113 Sentence Patients with sensitive disease respond to the same initial regimen in approximately 50% of cases; however, cumulative toxic effects may ensue 化疗敏感的患者中约有50%对相同方案仍有反应，但可能出现累积毒性反应
s114 Sentence All patients with this type of cancer may appropriately be considered for inclusion in clinical trials at the time of diagnosis 所有此类肿瘤患者在诊断时可考虑适合纳入临床试验
s115 Sentence At this time, sensitivity, specificity, and positive- or negative-predictive value of PET scanning and its enhancement of staging accuracy are uncertain 目前PET扫描的敏感性、特异性、阳性预测值、阴性预测值及其是否增强分期准确性尚不明确
s116 Sentence A study conducted by the Medical Research Council demonstrated similar efficacy for an etoposide plus vincristine regimen and a four-drug regimen 医学研究委员会进行的一项研究发现依托泊苷联合长春新碱的有效性与四药联合治疗的有效性相似
s117 Sentence In a study of 120 patients with LD SCLC or ED SCLC, ten patients were upstaged and three patients were downstaged 一项研究发现，在120例局限期和广泛期 SCLC患者中，10例患者分期上调，3例患者分期下调
s118 Sentence Because of differences in clinical behavior, therapy, and epidemiology, these tumors are classified separately in the World Health Organization (WHO) revised classification 因上述肿瘤的临床行为、治疗、流行病学均不相同，故修订版世界卫生组织（WHO）肿瘤分类法分别对这些肿瘤进行了分类
s119 Sentence Extensive-stage disease (ED) SCLC has spread beyond the supraclavicular areas and is too widespread to be included within the definition of LD 广泛期（ED）SCLC病变超出锁骨上区域，且超出局限期范围
s120 Sentence Prophylactic cranial radiation prevents central nervous system recurrence and can improve survival in patients who have had a complete response to chemoradiation 预防性脑照射有助于预防中枢神经系统复发并提高化疗后取得完全缓解的患者的生存
s121 Sentence Before initiating treatment of a patient with small cell lung cancer (SCLC), an experienced lung cancer pathologist should review the pathologic material 小细胞肺癌（SCLC）患者在开始治疗前，应有一位富有经验的肺癌病理科医师审核患者的病理学材料
s122 Sentence Patients diagnosed with LD who smoke should be encouraged to stop smoking before undergoing combined-modality therapy because continued smoking may compromise survival 应鼓励确诊局限期的吸烟患者在接受综合治疗之前先戒烟，因继续吸烟影响患者生存
s123 Sentence Estimated new cases and deaths from lung cancer (SCLC and non-small cell lung cancer [NSCLC] combined) in the United States in 2014: 据估计，2014年美国肺癌（NSCLC与SCLC）新发病例和死亡病例数分别为：
s124 Sentence There is no evidence of a difference in response rate, disease-free survival (DFS), or OS in older patients compared with younger patients 无证据支持老年患者的缓解率、无病生存时间（DFS）或OS与较年轻患者不同
s125 Sentence Secondary endpoints of median survival and 1-year survival rates were also similar (33 weeks vs. 35 weeks and 33% vs. 29%, respectively) 次要终点为中位生存时间与1年生存率，二者的次要终点结果相似（分别33周与35周；33%与29%）
s126 Sentence A retrospective review showed that 43% of patients treated with additional chemotherapy at the time of CNS relapse responded to second-line chemotherapy 一项回顾性综述发现CNS复发后增加化疗的患者中43%对二线化疗有良好反应
s127 Sentence Resistant patients either did not respond to first-line chemotherapy or responded initially but relapsed within 90 days of completion of their primary therapy 化疗耐药患者为一线治疗后未缓解或初次治疗后90天内复发的患者
s128 Sentence Patients presenting with superior vena cava syndrome are treated immediately with combination chemotherapy, radiation therapy, or both, depending on the severity of presentation 出现上腔静脉综合征的患者可根据症状严重度立即选择联合化疗、放疗或二者
s129 Sentence In patients with ED, median survival of 6 to 12 months is reported with currently available therapy, but long-term disease-free survival is rare 广泛期患者经当前治疗后的中位生存时间为6-12月，但长期无病生存十分罕见
s130 Sentence The median survival times for patients receiving topotecan plus BSC were 25.9 weeks versus 13.9 weeks for BSC alone ( P = .01) 拓扑替康加BSC组与单独BSC组的中位生存时间分别为25.9周与13.9周（P=0.01）
s131 Sentence Any cases showing at least 10% of SCLC are diagnosed as combined SCLC, and SCLC is limited to tumors with pure SCLC histology SCLC成分占至少10%的肿瘤诊断为混合型SCLC，组织学为单纯SCLC的肿瘤才称为SCLC
s132 Sentence Chemotherapy improves the survival of patients with limited-stage disease (LD) or extensive-stage disease (ED), but it is curative in only a minority of patients 尽管治疗已有显著进展，绝大多数SCLC患者经最佳治疗后仍然因肿瘤死亡
s133 Sentence Regardless of stage, the current prognosis for patients with SCLC is unsatisfactory despite improvements in diagnosis and therapy made during the past 25 years 尽管过去25年中SCLC的诊断和治疗有所发展，但除去分期因素，SCLC患者的预后大多不令人满意
s134 Sentence Combined-modality treatment with etoposide and cisplatin with thoracic radiation therapy (TRT) is the most widely used treatment for patients with limited-stage disease (LD) SCLC 依托泊苷联合顺铂加胸部放疗（TRT）的联合治疗方法是局限期（LD）SCLC患者最常用的治疗
s135 Sentence The IASLC conducted an analysis of clinical TNM staging for SCLC using the sixth edition of the AJCC TNM staging system for lung cancer IASLC使用第6版AJCC TNM肺癌分期系统对SCLC临床TNM分期进行分析
s136 Sentence For patients with LD, median survival of 16 to 24 months and 5-year survivals of 14% with current forms of treatment have been reported 据文献局限期患者经当前治疗后中位生存时间为16-24月，5年生存率为14%
s137 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with limited stage small cell lung cancer 从招募局限期小细胞肺癌患者的NCI癌症临床研究目录中可以筛选美国临床研究
s138 Sentence Although preinvasive and in situ malignant changes are frequently found in patients with non-small cell lung cancer, these findings are rare in patients with SCLC 尽管癌前病变和原位癌在非小细胞肺癌患者中较为常见，但在SCLC患者中很罕见
s139 Sentence The majority of these patients relapse only in their brain, and nearly all of those who relapse in their CNS die of their cranial metastases 其中绝大多数患者仅有脑部转移复发，几乎所有CNS复发患者均死于脑转移
s140 Sentence Patients with pleural effusion have an intermediate prognosis between LD and ED with hematogenous metastases and will be classified as having M1 disease (or ED) 有胸腔积液的患者预后介于局限期与伴有血源性转移的广泛期之间，这些患者为M1期（或广泛期）
s141 Sentence Patients receiving oral topotecan experienced less grade 4 neutropenia (47% vs. 64.2%) but more diarrhea of all grades (35.9% vs. 19.9%) than with intravenous topotecan 口服拓扑替康治疗的患者4度中性粒细胞减少症发生率降低（两组分别47%与64.2%），但各级腹泻发生率升高（两组分别35.9%与19.9%）
s142 Sentence The optimal duration of chemotherapy is not clearly defined, but no obvious improvement in survival occurs when the duration of drug administration exceeds 6 months 最佳治疗持续时间尚不明确，但给药持续时间超过6个月并不明显增加生存获益
s143 Sentence A randomized trial of 286 patients with response following four to six cycles of chemotherapy compared PCI versus no further therapy with symptomatic brain metastases 一项随机临床试验招募了286例4-6程化疗后缓解的患者，比较了当出现脑转移症状时行PCI与不行PCI的效果
s144 Sentence Randomized trials such as EORTC-22003-08004 and IFCT 99-01 have shown that doses higher than 25 Gy in 10 daily fractions do not improve long-term survival EORTC-22003-08004与IFCT 99-01等随机临床试验均显示总剂量大于25 Gy每日10次照射并不增加长期生存
s145 Sentence Physical examination may identify enlarged supraclavicular lymphadenopathy, pleural effusion or lobar collapse, unresolved pneumonia, or signs of associated disease such as chronic obstructive pulmonary disease 体格检查可能发现锁骨上淋巴结肿大、胸腔积液或肺不张、迁延性肺炎、或慢性阻塞性肺病或肺纤维化等合并症相关体征
s146 Sentence Patients with progressive intrathoracic tumor after failing initial chemotherapy can achieve significant tumor responses, palliation of symptoms, and short-term local control with external-beam radiation therapy 初次化疗失败后的进展性胸内肿瘤患者可通过外部放疗达到显著的肿瘤缓解、症状缓解并实现短期局部控制
s147 Sentence Clinical trials have consistently achieved median survivals of 18 to 24 months and 40% to 50% 2-year survival rates with less than a 3% treatment-related mortality 临床试验一致发现中位生存率18-24月，2年生存率40%-50%，治疗相关死亡率低于3%
s148 Sentence Without treatment, SCLC has the most aggressive clinical course of any type of pulmonary tumor, with median survival from diagnosis of only 2 to 4 months 如不经治疗，临床过程中SCLC是所有肺肿瘤中最具侵袭性的，距确诊的中位生存时间仅2-4月
s149 Sentence A study comparing chemotherapy every 3 weeks with treatment given as required for symptom control showed an improvement in QOL in those patients receiving regular treatment 一项研究比较了每3周一次化疗与不定期的对症治疗，研究结果发现接受定期治疗的患者QOL较佳
s150 Sentence Although this difference was not statistically significant, the trial was underpowered to prove equivalence of the two treatment regimens in patients with either LD or ED 但这一差异不具统计学显著性，该试验效力不足以证实两种治疗方案对局限期或广泛期患者的作用相同
s151 Sentence Survivals for patients with clinical stages I and II disease are significantly different from those for patients with stage III disease with N2 or N3 involvement 临床I、II期患者的生存时间与N2或N3的III期患者有显著差别
s152 Sentence As in other chemosensitive tumors (e.g., Hodgkin lymphoma and ovarian epithelial cancer), two main categories of patients receiving second-line chemotherapy have been described: sensitive and resistant 如其他化疗敏感的肿瘤（例如霍奇金淋巴瘤和卵巢上皮癌等），接受二线化疗的患者主要可分为两类：敏感和耐药患者
s153 Sentence At the time of diagnosis, approximately 30% of patients with SCLC will have tumors confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes 在诊断时，约30%的SCLC患者肿瘤局限在原发肿瘤半侧胸部或锁骨上淋巴结
s154 Sentence Doses and schedules used in current programs yield overall response rates of 50% to 80% and complete response rates of 0% to 30% in patients with ED 当前治疗计划所用的剂量与方案对广泛期患者总缓解率在50%-80%，完全缓解率在0%-30%
s155 Sentence The latter regimen was associated with a greater risk of toxic effects and early death but was superior with respect to palliation of symptoms and psychological distress 后者的毒性反应发生率和早期死亡率较高，但缓解症状、减少心理压力的效果优于前者
s156 Sentence Expandable metal stents can be safely inserted under local anesthesia via the bronchoscope, which results in improved symptoms and pulmonary function in patients with malignant airways obstruction 对于恶性肿瘤气道梗阻患者，可在局麻下经气管镜放入膨胀式金属内支架以缓解症状、改善肺功能
s157 Sentence Once-daily fractions to higher doses of greater than 60 Gy are feasible and commonly used; their clinical benefits are yet to be defined in phase III trials 总剂量大于60Gy，每日一次分割治疗的方案具可行性且被广泛使用，其临床获益仍待III期试验以明确
s158 Sentence Although long-term survivors have been reported among patients who received either surgery or chemotherapy alone, chemotherapy combined with thoracic radiation therapy (TRT) is considered the standard of care 虽然单独行手术或化疗的患者中也有长期生存者，但化疗联合胸部放疗（TRT）是目前的标准治疗
s159 Sentence Some patients with intrinsic endobronchial obstructing lesions or extrinsic compression caused by the tumor have achieved successful palliation with endobronchial laser therapy (for endobronchial lesions only) and/or brachytherapy 支气管内梗阻性病变或支气管外肿瘤压迫的患者中，一些患者通过经支气管镜激光治疗（仅适用于支气管内病变）和（或）近距离放射治疗后可成功缓解症状
s160 Sentence The optimal timing of TRT relative to chemotherapy has been evaluated in multiple trials and meta-analyses with the weight of evidence suggesting a small benefit to early TRT 多项临床试验与荟萃分析评估了TRT距化疗的最佳时机，证据显示早期TRT有少量获益
s161 Sentence In a randomized trial of 784 patients, the combination of oral topotecan given with cisplatin for 5 days was not found to be superior to etoposide and cisplatin 一项临床试验招募784例患者，结果显示口服拓扑替康联合顺铂治疗5天的有效性并不优于依托泊苷联合顺铂
s162 Sentence Response rates to combination agents are generally higher than those reported for single agents; however, many studies do not report the patients with sensitive, resistant, or refractory disease 联合治疗的缓解率通常优于单药治疗；但很多研究并未区别报道患者是敏感型、耐药型还是难治型
s163 Sentence Patients whose cancer can be controlled outside the brain have a 60% actuarial risk of developing central nervous system (CNS) metastases within 2 to 3 years after starting treatment 肿瘤控制在脑外范围的患者在开始治疗后2-3年内发生中枢神经系统（CNS）转移的风险为60%
s164 Sentence Irinotecan and cisplatin regimens led to less grade 3 to 4 anemia, neutropenia, and thrombocytopenia but more grade 3 to 4 vomiting and diarrhea than etoposide and cisplatin regimens 伊立替康联合顺铂方案的3-4级贫血、中性粒细胞减少症和血小板减少症发生率低于依托泊苷联合顺铂方案，但3-4级呕吐与腹泻的发生率高于依托泊苷联合顺铂方案
s165 Sentence Studies comparing a convenient oral treatment with single-agent oral etoposide versus combination therapy showed that the overall response rate and OS were significantly worse in the oral etoposide arm 一些研究比较了较为方便的口服依托泊苷单药治疗与联合治疗，结果显示口服依托泊苷组的总缓解率与总生存率显著低于联合治疗组
s166 Sentence (Refer to the Staging Evaluation section in the Stage Information for Small Cell Lung Cancer section of this summary for more information about tests and procedures used for staging.) （关于分期检查与过程的更多信息请参考本总结小细胞肺癌的分期信息部分的分期评估）
s167 Sentence The standard chemotherapy regimens for the general population could be applied to older patients in good general condition (i.e., performance status of 0–1, normal organ function, and no comorbidity) 故一般人群所用的标准化疗方案也可用于一般情况较佳的老年患者（即身体状况评分0-1分，器官功能正常，无合并症）
s168 Sentence A randomized study evaluating the role of surgery in addition to chemoradiation therapy enrolled 328 patients with LD SCLC and found no OS benefit with the addition of pulmonary resection 一项随机研究评估了手术联合化疗的作用，该研究共有328例局限期 SCLC患者入组，研究发现化疗联合肺切除术并不增加OS获益
s169 Sentence Radiation therapy to sites of metastatic disease unlikely to be immediately palliated by chemotherapy, especially brain, epidural, and bone metastases, is a standard treatment option for patients with ED SCLC 在广泛期 SCLC治疗中，对于化疗不太可能立即缓解症状的转移灶（尤其是脑、硬膜外与骨转移灶）放疗仍是标准治疗
s170 Sentence Results from phase II studies of drugs such as topotecan, irinotecan, and gemcitabine indicate that response rates to agents vary depending on whether patients have sensitive, resistant, or refractory disease 拓扑替康、伊立替康与吉西他滨等药物的多项II期临床研究发现对药物的治疗反应很大程度上取决于肿瘤为敏感性、耐药性还是难治性
s171 Sentence A meta-analysis of seven randomized trials evaluating the value of PCI in patients in complete remission reported improvement in brain recurrence, disease-free survival, and OS with the addition of PCI 一项荟萃分析纳入7项随机临床试验，评估PCI对完全缓解患者的作用，结果发现PCI减少脑转移复发、提高无病生存率和总生存率
s172 Sentence Determining the stage of cancer allows an assessment of prognosis and a determination of treatment, particularly when chest radiation therapy or surgical excision is added to chemotherapy for patients with LD 癌症分期有助于评估预后与决定治疗，尤其可帮助局限期患者决定化疗联合手术切除或者胸部放疗
s173 Sentence The optimal duration of chemotherapy for patients with LD SCLC is not clearly defined, but no improvement exists in survival after the duration of drug administration exceeds 3 to 6 months 局限期 SCLC患者的最佳治疗持续时间尚不明确，但给药持续时间超过3-6个月并不增加生存获益
s174 Sentence Prospective, randomized studies have shown that patients with a poor prognosis who are treated with conventional regimens live longer than those treated with the single-agent, low-dose regimens or abbreviated courses of therapy 一些前瞻性随机临床研究发现预后较差的患者经普通方案治疗后，生存时间大于接受单药、低剂量方案或缩短疗程的患者
s175 Sentence About 10% of the total population of SCLC patients remains free of disease during the 2 years from the start of therapy, which is the time period during which most relapses occur 只有约10%的SCLC患者在治疗后2年内无复发，而多数复发会在此期间发生
s176 Sentence Although second-line chemotherapy has been shown to produce tumor regression, responses are usually short lived; the median survival is rarely more than 12 months and usually less than 6 months after second-line therapy 虽然有研究显示二线化疗可缩小肿瘤，但缓解期通常较短，中位生存时间很少超过12个月，二线治疗后中位生存时间通常短于6个月
s177 Sentence Application of the TNM system will not change how patients are managed; however, the analysis suggests that, in the context of clinical trials in LD, accurate TNM staging and stratification may be important TNM分期不影响患者治疗，但该分析显示在局限期临床试验中，准确的TNM分期与分层均很重要
s178 Sentence No consistent survival benefit has resulted from platinum versus nonplatinum combinations, increased dose intensity or dose density, altered mode of administration (e.g., alternating or sequential administration) of various chemotherapeutic agents, or maintenance chemotherapy 铂类和非铂类联合化疗、增加剂量或给药频次、改变不同化疗药的给药方式（例如更换或序贯给药）或维持化疗相比，并无一致的生存获益
s179 Sentence Chemotherapy for patients with extensive-stage disease (ED) SCLC is commonly given as a two-drug combination of platinum and etoposide in doses associated with at least moderate toxic effects (as in limited-stage [LD] SCLC) 广泛期（ED）SCLC患者的化疗常为铂类与依托泊苷两药联合治疗，所用剂量与至少中度毒性反应相关（与局限期[LD]SCLC相似）
s180 Sentence In an analysis of four trials, the completion of therapy in less than 30 days was associated with an improved 5-year survival rate (relative risk, 0.62; 95% confidence interval, 0.49–0.80; P = .0003) 对4项临床试验的分析显示，少于30天内完成治疗可提高5年生存率（相对风险，0.62；95%置信区间，0.49-0.80；P=0.0003）
s181 Sentence Neuroendocrine and neural differentiation result in the expression of dopa decarboxylase, calcitonin, neuron-specific enolase, chromogranin A, CD56 (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and insulin-like growth factor 1 神经内分泌分化与神经分化的肿瘤表达多巴脱羧酶、降钙素、神经元特异性烯醇酶、嗜铬粒蛋白A、CD56（也称为核小体组蛋白激酶1或神经细胞黏附分子）、胃泌素释放肽和胰岛素样生长因子1
s182 Sentence No specific phase III trial in older patients with LD SCLC has been reported; however, three secondary analyses of two cooperative group trials have been published evaluating outcomes in patients aged 70 years or older 目前尚无已发表的专门针对局限期SCLC老年患者开展的III期临床试验，但已发表的2个协作组研究中共3项次要分析评估了年龄大于等于70岁老年患者的结果
s183 Sentence Given the absence of data from randomized trials, the role of surgery in the management of individual patients with SCLC must be considered, both in terms of potential benefit and risk from the surgical procedure 因缺乏随机临床试验证据，讨论手术对单个SCLC患者的作用时必须考虑到手术的潜在获益及其风险
s184 Sentence The following results have been reported in clinical trials: Mature results of prospective randomized trials suggest that combined-modality therapy produces a modest but significant improvement in survival of 5% at 3 years compared with chemotherapy alone 临床试验中发现下列结果：一些前瞻性随机临床试验的结果发现综合治疗相对于单纯化疗可使得3年生存率提高5%
s185 Sentence The 1-year survival rate was 31% (95% confidence interval [CI], 27%–36%) and was deemed to be noninferior, as the difference of -0.03 met the predefined criteria of no more than 10% absolute difference in 1-year survival 1年生存率为31%（95%置信区间[CI]，27%-36%），生存率差异为-0.03，在预设的1年生存率绝对差异不超过10%范围内，故不劣于依托泊苷联合顺铂
s186 Sentence Because the older patients enrolled in these phase III trials may not be representative of LD SCLC patients in the general population, caution must be exercised in extrapolating these results to the general population of older patients 因为该III期临床试验纳入的老年患者可能并非普通人群中局限期SCLC患者的典型代表，故将这些结果推广至普通老年人群必须慎重
s187 Sentence Multiple clinical trials and meta-analyses addressing the timing of TRT have been published, with the weight of evidence suggesting a small benefit to early TRT (i.e., TRT administered during the first or second cycle of chemotherapy administration) 多项已发表的临床试验与荟萃分析研究了TRT的治疗时机，证据权重提示早期TRT（即第一程或第二程化疗期间给予TRT）可能有少量获益
s188 Sentence At the time of initial diagnosis, approximately two-thirds of patients with SCLC have clinical evidence of metastases; most of the remaining patients have clinical evidence of extensive nodal involvement in the hilar, mediastinal, and sometimes supraclavicular regions 确诊时约有三分之二的SCLC患者有转移证据，其余多数患者有肺门、纵膈广泛淋巴结受累，部分患者也有锁骨上区淋巴结受累
s189 Sentence A phase III trial comparing chemotherapy with best supportive care (BSC) in relapsed SCLC patients demonstrated that the addition of oral topotecan to BSC significantly increased overall survival and resulted in better symptom control compared with BSC alone 一项III期临床试验比较了化疗与最佳支持治疗（BSC）对SCLC复发患者的作用，结果显示BSC加口服拓扑替康显著提高总生存率，其症状控制效果优于单独BSC
s190 Sentence A randomized, phase III trial ( CWRU-SKF-1598 ) of 304 patients assessed the use of oral topotecan (2.3 mg/m2 /day for 5 days every 21 days) or intravenous topotecan (1.5 mg/m2 /day for 5 days every 21 days) 一项III期随机临床试验（CWRU-SKF-1598）对304例患者评估了口服拓扑替康（2.3 mg/m2/日，持续5天，每疗程21天）或静脉用拓扑替康（1.5 mg/m2/日，持续5天，每疗程21天）
s191 Sentence SCLC is more responsive to chemotherapy and radiation therapy than other cell types of lung cancer; however, a cure is difficult to achieve because SCLC has a greater tendency to be widely disseminated by the time of diagnosis SCLC对化疗和放疗的反应优于其他类型的肺癌，但因SCLC在诊断时广泛扩散的可能性更大，故很难达到治愈效果
s192 Sentence A randomized comparison of second-line treatment with either cyclophosphamide, doxorubicin, and vincristine (CAV) or topotecan in patients with sensitive disease reported no significant difference in response rates or survival, but palliation of common lung cancer symptoms was better with topotecan 一项随机临床研究比较了环磷酰胺、阿霉素与长春新碱二线化疗方案（CAV）与拓扑替康对化疗敏感肿瘤患者的作用，研究发现缓解率或生存率无显著差异，但拓扑替康组的肺癌症状缓解效果更佳
s193 Sentence A randomized study ( RTOG-0212 ) of 720 patients with LD SCLC in complete remission after chemoradiation therapy demonstrated that standard-dose PCI (25 Gy in 10 fractions) was as effective as and less toxic than higher doses of brain radiation 一项随机研究（RTOG-0212）招募了720例放化疗后完全缓解的局限期 SCLC患者，研究显示标准剂量PCI（25Gy分10次照射）的有效性与更高剂量脑照射相同，且毒性更小
s194 Sentence There was a significant increase in treatment-related mortality in the EST-3588 trial that compared etoposide and cisplatin with either once-daily or twice-daily radiation therapy (1% for patients aged <70 years vs. 10% for patients aged ≥70 years; P = .01) EST-3588试验比较了依托泊苷联合顺铂加每日一次或每日两次放疗的效果，发现老年患者的治疗相关死亡率显著升高（年龄＜70岁患者为1%，年龄≥70岁患者为10%；P=0.01）
s195 Sentence Small case series and population studies have reported favorable outcomes for the minority of LD patients with very limited disease, with small tumors pathologically confined to the lung of origin or the lung and ipsilateral hilar lymph nodes from surgical resection with adjuvant chemotherapy 一些小型病例分析研究与人群研究报道了少数非常局限的肿瘤：局限于原发肺的小肿瘤或经手术加辅助化疗的局限于肺和同侧肺门淋巴结的患者预后较佳
s196 Sentence The variant form of SCLC called mixed small cell/large cell carcinoma was not retained in the revised WHO classification. Instead, SCLC is now described with only one variant, SCLC combined, when at least 10% of the tumor bulk is made of an associated non-small cell component 新版WHO分类中不再包括SCLC变异型--混合小细胞/大细胞癌，现在SCLC仅有一种变异型，即混合型SCLC，肿块中至少含有10%非小细胞肿瘤成分
s197 Sentence Subgroup analyses of phase II and phase III trials of SCLC patients by age showed that myelosuppression and doxorubicin-induced cardiac toxic effects were more severe in older patients than in younger patients and that the incidence of treatment-related death tended to be higher in older patients 按患者年龄对II期、III期SCLC试验进行亚组分析，结果显示老年患者发生的骨髓抑制与阿霉素引起的心脏毒性反应严重程度大于较年轻患者，且老年患者的治疗相关死亡率似乎升高
s198 Sentence However, a meta-analysis of 14 published, randomized trials assessing the benefit of duration/maintenance therapy reported an odds ratio of 0.67 for both 1- and 2-year overall survival (OS) of 0.67 (95% CI, 0.56–0.79; P < .001 for 1-year OS and 0.53–0.86; P < .001 for 2-year OS) 但对14项评估治疗持续时间/维持治疗获益的已发表随机临床试验行荟萃分析，结果显示1年总生存率的比值比为0.67，2年总生存率的比值比为0.67（1年OS：95%CI，0.56-0.79；P＜0.001；2年OS：95%CI，0.53-0.86；P＜0.001）
s199 Sentence Symptoms may result from local invasion or compression of adjacent thoracic structures, such as compression involving the esophagus causing dysphagia, compression involving the laryngeal nerves causing hoarseness, or compression involving the superior vena cava causing facial edema and distension of the superficial veins of the head and neck 症状产生的原因可能是肿瘤局部侵袭或对临近胸腔结构的压迫，例如压迫食管引起吞咽困难，压迫喉神经引起声音嘶哑，压迫上腔静脉引起面部水肿、头颈部浅静脉扩张等
s200 Sentence Both once-daily and twice-daily chest radiation schedules have been used in regimens with etoposide and cisplatin. One randomized study showed a modest survival advantage in favor of twice-daily radiation therapy given for 3 weeks compared with once-daily radiation therapy to 45 Gy given for 5 weeks (26% vs. 16% at 5 years; P = .04) 一些研究在依托泊苷联合顺铂化疗方案中增加每日一次和每日两次胸部照射方案一项随机临床研究显示每日两次照射持续3周相较于每日一次照射持续5周（总剂量45Gy）有中度生存率获益（5年生存率分别26%与16%；P=0.04）