摘要
目的回顾性分析不能手术的早期非小细胞肺癌患者放疗结果。方法搜集5年间58例因内科疾病不能手术的非小细胞肺癌患者，其中I期37例，Ⅱ期21例。50例单纯放疗，8例放疗＋化疗。43例三维适形放疗，15例常规放疗。结果全组1、2、3年生存率分别为85％、54％、30％，中位生存时间26．2个月。1、2、3年肿瘤专项生存率分别为88％、60％、36％，中位生存时间30．8个月；I期的分别为84％、64％、31％和30．8个月，Ⅱ期的分别为81％、47％、28％和18．8个月；三维适形放疗的分别为95％、57％、33％和30．8个月，常规放疗的分别为53％、44％、24％和15．3个月。单因素分析显示肿瘤体积、放射性肺损伤和体重下降≥5％显著影响生存率，多因素回归分析显示肿瘤体积是独立预后因素。2级以上放射性肺炎和放射性食管炎的发生率分别为16％和2％，年龄和疗前肺功能与2级以上放射性肺炎的发生有显著相关性。治疗失败原因包括局部失败（33％）和远处转移（21％），各治疗组间无差别。结论不能手术的早期非小细胞肺癌患者的肿瘤体积是影响生存的最主要因素，三维适形放疗较常规放疗能提高生存率。高龄和肺功能差的患者出现放射性肺炎的概率较大。
Objective To retrospectively analyze treatment results of radiotherapy for medically in- operable stage I/Ⅱ non-small cell lung cancer. Methods Between Jan. 2000 and Dec. 2005, fifty-eight such patients were enrolled into the database analysis, including 37 with clinical stage I and 21 with stage Ⅱ disease. Fifty patients received radiotherapy alone and eight with radiotherapy and chemotherapy. Forty-three patients were treated with 3-D conformal radiotherapy （3D-CRT） and 15 with conventional radiotherapy. Results The 1-,2- and 3-year overall survival rates were 85%, 54% and 30%, and the median sur- vival time was 26.2 months for the whole group. The corresponding figures were 88% ,60% ,36% and 30.8 months for cancer-specific survival; 84% ,64% ,31% and 30.8 months for Stage I disease; 81% ,47% , 28% and 18.8 months for Stage Ⅱ disease;95%, 57% , 33% and 30.8 months for 3D-CRT group and 53% , 44%, 24% and 15.3 months for conventional radiotherapy group. By logrank test, tumor volume, pneumonitis of Grade Ⅱ or higher and weight loss more than 5% showed statistically significant impact on overall survival. Tumor volume was the only independent prognostic factor in Cox multivariable regression. Pneumonitis and esophagitis of Grade Ⅱ or higher were 16% and 2%, respectively. Age and lung function before treatment had a significant relationship with pneumonitis. Failure included the local recurrence （ 33% ） and distant metastasis （21%）. There was no difference between the treatment modalities and failure sites. Conclusions For medically inoperable early stage non-small cell lung cancer patients, tumor volume is the most important prognostic factor for overall survival. The conformal radiotherapy marginally improves the survival. The age and pulmonary function are related to the incidence of treatment induced pneumonitis.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2008年第2期101-105,共5页
Chinese Journal of Radiation Oncology
关键词
癌
非小细胞肺癌/放射疗法
生存分析
副反应
Carcinoma, non-small cell lung/radiotherapy
Survival analysis
Side-response
