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Ⅲa(N2)期非小细胞肺癌术后放疗的疗效评价

Therapeutic Evaluation of Postoperative Radiotherapy for Patients with Completely Resected Stage Ⅲa(N2) Non-Small Cell Lung Cancer

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【作者】 曹卡加黄惠英练小荷崔念基

【Author】 CAO Ka-jia*, HUANG Hui-ying, LIAN Xiao-he, CUI Nian-ji Radiotherapy Department, Cancer Center, Sun Yat-sen University of Medical Sciences, Guangzhou 510060, P.R.China

【机构】 中山医科大学肿瘤防治中心放疗科!广东广州 510060

【摘要】 目的:评价Ⅲ a (N2)期非小细胞肺癌全切除术后放疗的疗效。方法: 1989年 1月至 1993年 12月,在我院接受根治手术的非小细胞肺癌病人中有 119例无肉眼和镜下残留、病理分期为Ⅲ a(N2)期的非小细胞肺癌,其中 55例接受术后放疗(综合组), 64例没有放疗(手术组)。综合组病人于术后 28~ 53天开始照射患侧肺门和纵隔,总照射剂量为 46~ 62 Gy(中位数 56 Gy) ,在 5~ 7周内分 23~ 31次完成。用寿命表及 Log-rank法计算和比较两组病人的生存率与局控率。结果:两组病人的年龄、性别、病理类型等基本相同。综合组和手术组病人的 5年生存率分别为 25.5%和 23.0%( P >0.05)。综合组病人从手术到肿瘤复发的中位时间为 21个月( 9~ 40个月),而手术组为 12个月( 5~ 46个月),两组比较有显著性差异( P< 0.05)。综合组病人 1、 3、 5年局控率分别为 94.0%、 78.5%、 69.0%,明显高于手术组的 83.1%、 58.3%、 50.6% (P< 0.05)。综合组的 5年远处转移率为 54.5%( 30/55),手术组为 40.6%( 26/64),两组比较无显著性差异( P >0.05)。结论:术后放疗能提高Ⅲ a(N2)期非小细胞肺癌全切除术后病人的局控率,并延长复发出现的时间,但未能改善其生存率。

【Abstract】 Objective: A retrospective study was conducted to evaluate the efficiency of postoperative radiotherapy for completely resected, pathologically StageⅢ a (N2) non-small cell lung cancer (NSCLC). Methods: From January 1989 to December 1993, among the patients with NSCLC who underwent radical surgery in the authors hospital, there were 119 patients with completely resected, pathologically StageⅢ a(N2)NSCLC. A total of 55 cases of these patients received postoperative radiotherapy with dose of 46- 62 gray in mediastinum and hilus (S+ RT group), except other 64 cases (S group). The survival rates and local control rates were analyzed and compared by the life table and Log-rank. Results: The clinical characters of patients such as age, sex, pathologic type were similar between two groups. The 1,3,5-year survival rates were 80.0% , 32.7% , 25.5% respectively in S+ RT group and 76.4% , 36.4% , 23.0% respectively in S group, with no significant difference between two groups( P >0.05) . The median time of local recurrence was 21 months in S+ RT group and 12 months in S group, with significant difference between two groups(P< 0.05) . The 1,3,5-year local control rates were 94.0% , 78.5% , 69.0% respectively in S+ RT group in contrast to 83.1% , 58.3% , 50.6% respectively in S group(P< 0.05). The metastasis rates were similar in two groups( P >0.05) . Conclusion: Postoperative radiotherapy can increase the local control rates and prolong the time of local recurrence for the patients with completely resected, pathologically StageⅢ a (N2) NSCLC, but the survival rate can not be improved.

  • 【文献出处】 癌症 ,Chinese Journal of Cancer , 编辑部邮箱 ,2001年03期
  • 【分类号】R734.2
  • 【被引频次】8
  • 【下载频次】104
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