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。
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.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2001年第3期305-307,共3页
Chinese Journal of Cancer
关键词
非小细胞肺癌
外科手术
放射治疗
： Non-small cell lung cancer
Surgery
Non-small cell lung cancer
Radiotherapy
Therapeutic evaluation
