摘要
目的回顾性分析根治性放疗的非小细胞肺癌(NSCLC)病例,探讨肿瘤局部因素对放疗疗效的影响。方法接受根治性放疗并经病理或细胞学证实的Ⅰ～Ⅲb期NSCLC75例。常规放疗39例,适形放疗36例,总剂量60～70Gy,30～35分次,6～7周完成。由CT扫描测量肿瘤最大直径及体积,对相关指标进行单因素、多因素分析,并用预后指数模型综合评价放疗疗效。结果完全缓解(CR)率33.3%(25/75),有效率(CR+PR)率85.3%(64/75),无变化加病变进展(NC+PD)率14.7%(11/75)。中位生存期13.8个月,1.0、1.5年生存率分别为54.7%、27.5%。单因素及多因素分析显示原发肿瘤直径较小、体积较小、T分期较早、总治疗时间较短和放射性肺炎较轻者预后较好。预后指数能够更敏感地预测放疗疗效。结论原发肿瘤直径、肿瘤体积、T分期、总治疗时间、急性放射性肺炎有可能成为放疗NSCLC的独立影响因素,预后指数模型能够显著提高多指标联合的预测价值。
Objective To evaluate the impact of tumor local factors on radiotherapy in non-small cell lung cancer(NSCLC). Methods From Jan.2000 to Jun.2002, 75 stageⅠ～Ⅲb NSCLC patients who received definitive radiotherapy were analyzed retrospectively. Thirty-nine patients treated by conventional radiotherapy and 36 by three dimensional radiotherapy with 60-70?Gy/30-35F/6-7w. The tumor diameter and volume were measured on CT scans. The impact of related prognostic factors on survival was evaluated by univariate and multivariate analysis. The treatment outcome was analyzed by prognostic index model. Results The complete response (CR)was 33.3%(25/75), partial response was 52.0%(39/75)and median survival time was 13.8 months. The 1.0-,1.5-year survival rates were 54.7% and 27.5%, respectively. Smaller tumor diameter and volume, earlier T stage, shorter overall treatment time and milder acute radiation pneumonitis were favorable factors for survival when analyzed by univariate and multivariate. Prognostic index was higher sensitivity for predicting treatment outcome. Conclusions Tumor diameter, tumor volume, T stage, overall treatment time,milder acute radiation-induced pneumonitis are likely to be independent prognostic factors. Prognostic index model may well raise the predictive value of multivariate analysis for NSCLC treated by radiotherapy.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2005年第4期245-248,共4页
Chinese Journal of Radiation Oncology
基金
河北省医学重点学科跟踪项目资助(320.675)
