中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2008年
2期
101-105
,共5页
张莉%王绿化%张红星%陈东福%肖泽芬%汪楣%冯勤付%梁军%周宗玫%欧广飞%吕纪马%殷蔚伯
張莉%王綠化%張紅星%陳東福%肖澤芬%汪楣%馮勤付%樑軍%週宗玫%歐廣飛%呂紀馬%慇蔚伯
장리%왕녹화%장홍성%진동복%초택분%왕미%풍근부%량군%주종매%구엄비%려기마%은위백
癌,非小细胞肺癌/放射疗法%生存分析%副反应
癌,非小細胞肺癌/放射療法%生存分析%副反應
암,비소세포폐암/방사요법%생존분석%부반응
Carcinoma,non-small cell lung/radiotherapy%Survival analysis%Side-response
目的 回顾性分析不能手术的早期非小细胞肺癌患者放疗结果.方法 搜集5年间58例因内科疾病不能手术的非小细胞肺癌患者,其中Ⅰ期37例,Ⅱ期21例.50例单纯放疗,8例放疗+化疗.43例三维适形放疗,15例常规放疗.结果 全组1、2、3年生存率分别为85%、54%、30%,中位生存时间26.2个月.1、2、3年肿瘤专项生存率分别为88%、60%、36%,中位生存时间30.8个月;Ⅰ期的分别为84%、64%、31%和30.8个月,Ⅱ期的分别为81%、47%、28%和18.8个月;三维适形放疗的分别为95%、57%、33%和30.8个月,常规放疗的分别为53%、44%、24%和15.3个月.单因素分析显示肿瘤体积、放射性肺损伤和体重下降≥5%显著影响生存率,多因素回归分析显示肿瘤体积是独立预后因素.2级以上放射性肺炎和放射性食管炎的发生率分别为16%和2%,年龄和疗前肺功能与2级以上放射性肺炎的发生有显著相关性.治疗失败原因包括局部失败(33%)和远处转移(21%),各治疗组间无差别.结论 不能手术的早期非小细胞肺癌患者的肿瘤体积是影响生存的最主要因素,三维适形放疗较常规放疗能提高生存率.高龄和肺功能差的患者出现放射性肺炎的概率较大.
目的 迴顧性分析不能手術的早期非小細胞肺癌患者放療結果.方法 搜集5年間58例因內科疾病不能手術的非小細胞肺癌患者,其中Ⅰ期37例,Ⅱ期21例.50例單純放療,8例放療+化療.43例三維適形放療,15例常規放療.結果 全組1、2、3年生存率分彆為85%、54%、30%,中位生存時間26.2箇月.1、2、3年腫瘤專項生存率分彆為88%、60%、36%,中位生存時間30.8箇月;Ⅰ期的分彆為84%、64%、31%和30.8箇月,Ⅱ期的分彆為81%、47%、28%和18.8箇月;三維適形放療的分彆為95%、57%、33%和30.8箇月,常規放療的分彆為53%、44%、24%和15.3箇月.單因素分析顯示腫瘤體積、放射性肺損傷和體重下降≥5%顯著影響生存率,多因素迴歸分析顯示腫瘤體積是獨立預後因素.2級以上放射性肺炎和放射性食管炎的髮生率分彆為16%和2%,年齡和療前肺功能與2級以上放射性肺炎的髮生有顯著相關性.治療失敗原因包括跼部失敗(33%)和遠處轉移(21%),各治療組間無差彆.結論 不能手術的早期非小細胞肺癌患者的腫瘤體積是影響生存的最主要因素,三維適形放療較常規放療能提高生存率.高齡和肺功能差的患者齣現放射性肺炎的概率較大.
목적 회고성분석불능수술적조기비소세포폐암환자방료결과.방법 수집5년간58례인내과질병불능수술적비소세포폐암환자,기중Ⅰ기37례,Ⅱ기21례.50례단순방료,8례방료+화료.43례삼유괄형방료,15례상규방료.결과 전조1、2、3년생존솔분별위85%、54%、30%,중위생존시간26.2개월.1、2、3년종류전항생존솔분별위88%、60%、36%,중위생존시간30.8개월;Ⅰ기적분별위84%、64%、31%화30.8개월,Ⅱ기적분별위81%、47%、28%화18.8개월;삼유괄형방료적분별위95%、57%、33%화30.8개월,상규방료적분별위53%、44%、24%화15.3개월.단인소분석현시종류체적、방사성폐손상화체중하강≥5%현저영향생존솔,다인소회귀분석현시종류체적시독립예후인소.2급이상방사성폐염화방사성식관염적발생솔분별위16%화2%,년령화료전폐공능여2급이상방사성폐염적발생유현저상관성.치료실패원인포괄국부실패(33%)화원처전이(21%),각치료조간무차별.결론 불능수술적조기비소세포폐암환자적종류체적시영향생존적최주요인소,삼유괄형방료교상규방료능제고생존솔.고령화폐공능차적환자출현방사성폐염적개솔교대.
Objective To retrospectively analyze treatment results of radiotherapy for medically inoperable stage Ⅰ/Ⅱ non-small cell lung cancer. Methods Between Jan.2000 and Dec.2005,fifty-eight such patients were enrolled into the database analysis,including 37 with clinical stage Ⅰ and 21 with stage Ⅱ disease.Fifty patients received radiotherapy alone and eight with radiotherapy and chemotherapy.Fortythree patients were treated with 3-D conformal radiotherapy(3D-CRT)and 15 with conventional radiotherapy.Results The 1-,2-and 3- year overall survival rates were 85%,54%and 30%,and the median survival time was 26.2 months for the whole group.The corresponding figures were 88%,60%,36%and 30.8 months for cancer-specific survival:84%,64%,31%and 30.8 months for Stage Ⅰ disease;81%,47%,28%and 18.8 months for Stage Ⅱ disease;95%,57%,33%and 30.8 months for 3D-CRT group and 53%,44%,24%and 15.3 months for conventional radiotherapy group.By logrank test,tumor volume,pneumonitis of Grade Ⅱ or higher and weight loSS more than 5%showed statistically significant impact on overall survival.Tumor volume was the only independent prognostic factor in Cox muhivariable regression.Pneumonitis and esophagitis of Grade Ⅱ or higher were 16%and 2%,respectively.Age and lung function before treatment had a significant relationship with pneumonitis.Failure included the local recurrence(33%)and distant metastasis(21%).There was no difference between the treatment modalities and failure sites. Conclusions For medically inoperable early stage non-small cell lung cancer patients,tumor volume is the most important prognostic factor for overall survival.The conformal radiotherapy marginally improves the survival.The age and pulmonary function are related to the incidence of treatment induced pneumonitis.
