【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。更多还原

【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.更多还原