CAJ | 학술논문

　　背景与目的：术后放射治疗(postoperative radiotherapy，PORT)在完全性切除的ⅢA(N2)期非小细胞肺癌(non-small cell lung cancer，NSCLC)治疗中的临床价值存在争议。本研究分析PORT在完全性切除的ⅢA(N2)期NSCLC的疗效。方法：回顾性分析2002年1月—2007年1月126例在我院接受手术治疗的ⅢA(N2)期NSCLC患者的临床资料。根据是否行术后放疗分为术后化疗组(n=56)和术后放化疗组(n=70)，分析ⅢA(N2)期NSCLC生存期的影响因素。统计分析采用Kaplan-Meier法计算生存率，采用Log-rank比较各组生存的差异。结果：全组患者中位生存期25.0个月，1、3、5年生存率分别为84.4%、32.5%、16.4%。术后化疗组1、3、5年生存率分别为81.2%、28.5%、13.5%，中位生存期为22.4个月，术后化疗联合放疗组1、3、5年生存率分别为88.5%、39.9%、20.0%，中位生存期32.8个月，差异有统计学意义(P=0.033)。术后化疗组出现局部复发的中位时间为9.6个月，术后化疗联合放疗组出现局部复发的中位时间为17.0个月，差异有统计学意义(P=0.001)。单因素分析发现，多站淋巴结转移(P=0.001)、PORT(P=0.033)影响ⅢA(N2)期NSCLC的生存率。结论：术后辅助放疗可提高pN2期NSCLC的生存率和降低局部复发。
　　배경여목적：술후방사치료(postoperative radiotherapy，PORT)재완전성절제적ⅢA(N2)기비소세포폐암(non-small cell lung cancer，NSCLC)치료중적림상개치존재쟁의。본연구분석PORT재완전성절제적ⅢA(N2)기NSCLC적료효。방법：회고성분석2002년1월—2007년1월126례재아원접수수술치료적ⅢA(N2)기NSCLC환자적림상자료。근거시부행술후방료분위술후화료조(n=56)화술후방화료조(n=70)，분석ⅢA(N2)기NSCLC생존기적영향인소。통계분석채용Kaplan-Meier법계산생존솔，채용Log-rank비교각조생존적차이。결과：전조환자중위생존기25.0개월，1、3、5년생존솔분별위84.4%、32.5%、16.4%。술후화료조1、3、5년생존솔분별위81.2%、28.5%、13.5%，중위생존기위22.4개월，술후화료연합방료조1、3、5년생존솔분별위88.5%、39.9%、20.0%，중위생존기32.8개월，차이유통계학의의(P=0.033)。술후화료조출현국부복발적중위시간위9.6개월，술후화료연합방료조출현국부복발적중위시간위17.0개월，차이유통계학의의(P=0.001)。단인소분석발현，다참림파결전이(P=0.001)、PORT(P=0.033)영향ⅢA(N2)기NSCLC적생존솔。결론：술후보조방료가제고pN2기NSCLC적생존솔화강저국부복발。
Background and purpose: Postoperative radiotherapy (PORT) in completely resectable stageⅢA(N2) non-small cell lung cancer (NSCLC) is still controversial. The purpose of this study was to analyze the efficiency of PORT in completely resectable stageⅢA(N2) NSCLC. Methods:The clinical data of 126 patients with stageⅢA(N2) NSCLC who was treated with radical surgery from Jan. 2002 to Jan. 2007 were retrospectively analyzed. There were 126 patients for analysis; 70 patients received the postoperative chemotherapy alone (non-PORT), 56 patients received postoperative chemotherapy with radiotherapy. The 126 patients were analyzed the influencing factors of the overall survival (OS). Kaplan-Meier method was used to calculate the OS, and Log-rank was used to compare the difference of OS between the two groups. Results:The median survival time was 25.0 months in all the groups of patients. The 1-, 3-, 5-year survival rates were 84.4%, 32.5%, 16.4%. The 1-, 3-, and 5-year survival rates were 81.2%, 28.5%, 13.5%in non-PORT group, and 88.5%, 39.9%, 20.0%in PORT group. The median survival time was 22.4 months and 32.8 months, the difference was statistically significant (P=0.033). The median time of stageⅢA(N2) NSCLC with locoregional recurrence was 9.6 months in non-PORT group and 17.0 months in PORT group, the difference was statistically significant (P=0.001). Univariate analysis showed that the number of lymph node metastasis station (P=0.001) and PORT (P=0.033) correlated with OS. Conclusion:PORT could improve the survival rate and reduce the locoregional recurrence of stageⅢA(N2) NSCLC.