【摘要】 目的:分析发生单器官转移的非小细胞肺癌(NSCLC)患者化疗同期胸部三维放疗联合转移灶放疗的疗效及预后影响因素。方法:我院2003-01-23-2010-07-06收治Ⅳ期NSCLC化疗同期胸部三维放疗的201例患者,选取其中单器官转移且原发灶和转移灶均放疗的75例患者作为研究对象,对疗效及预后因素进行分析,Kaplan-Meier法计算生存率并Log-rank检验,Cox回归模型行多因素预后分析。结果:75例患者中,单纯脑转移20例,骨转移33例,其他转移22例。中位随访时间10个月(3～55个月),中位生存期为11.0个月(95%CI为7.5～14.5),1、2和3年生存率分别为49.6%、20.8%和12.1%。脑转移的中位生存期9.0个月(95%CI为6.5～15.5),骨转移的中位生存期14.0个月(95%CI为9.1～22.5),其他单器官转移的中位生存期11.0个月(95%CI为8.8～13.2)。胸部原发灶放疗处方剂量≥63Gy和<63Gy的中位生存期分别为17.0个月(95%CI为13.0～21.0)和9.0个月(95%CI为7.0～11.0)。多因素分析显示,转移部位和胸部原发灶放疗的剂量是影响总生存的独立预后因素。结论:单器官转移的NSCLC化疗同期胸部三维放疗+转移病灶放疗疗效较好,胸部原发灶较高剂量放疗及骨转移患者生存获益较大。更多还原

【Abstract】 OBJECTIVE: To evaluate the treatment outcomes and predictive factors of patients with non-small cell lung cancer and single organ metastasis treated with metastatic lesions radiotherapy and concurrent chemoradiotherapy.METHODS: Clinical data of 75 NSCLC patients with single organ metastases were collected,all patients received radiation to primary tumor and metastatic lesions.The Kaplan-Meier method was used to calculate the OS.The Log-rank test was used to compare the survival curves.Multivariate cox regression analyses was used to test independent significant prognostic factors for OS.RESULTS: For the whole group,20 patients had brain metastasis,33 had bone metastasis,and 22 patients with other organ metastasis.The median follow-up period was 10.0 months(range,3-55).The median survival time(MST) was 11.0 months(95%CI:7.5-14.5),and the 1-,2-and 3-year overall survival rate was 49.6%,20.8% and 12.1%,respectively.The MST was 9.0 months(95%CI:6.5-15.5) for patients with brain metastasis,14.0 months(95%CI:9.1-22.5) for those with bone metastasis,and 11.0 months(95%CI:8.8-13.2) for patients with other organ metastasis.The MST was 17.0 months(95%CI:13.0-21.0) for patients with thoracic radiation prescribed dose ≥63 Gy,whereas 9.0 months(95%CI:7.0-11.0) for those with dose <63 Gy.Multivariate analysis showed that the significant prognostic factors included the organ of metastasis and thoracic radiation dose.CONCLUSION: System chemotherapy with concurrent thoracic three dimensional radiotherapy and metastatic lesions radiotherapy for patients with NSCLC and single organ metastasis yielded satisfactory overall survival;and those with bone metastasis and higher radiation dose to primary thoracic tumor had better treatment outcome.更多还原