CAJ | 학술논문

目的比较局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)同步放化疗与序贯放化疗的疗效.方法回顾性分析2002年3月至2012年10月北京协和医院收治的经病理学确诊的初治局部晚期NSCLC患者121例,根据治疗方式分为同步放化疗组(n=66)与序贯放化疗组(n=55).比较两组患者的客观疗效、总生存期(overall survival,OS)和无进展生存期(progress-free survival,PFS).采用x2检验比较计数资料,t检验比较两样本均数,Kaplan-Meier方法比较OS和PFS.结果 121例局部晚期NSCLC患者的中位OS和PFS分别为23.1个月和10.7个月.同步放化疗组与序贯放化疗组的客观有效率分别为45.5％和16.4％,疾病控制率分别为84.8％和61.8％,中位OS分别为33.4个月和19.7个月,中位PFS分别为12.7个月和9.8个月,两组间比较差异均有统计学意义(x2=10.128,P＜0.05).同步放化疗后手术10例,中位OS和PFS均未达到.结论同步放化疗与序贯放化疗相比能明显提高局部晚期NSCLC的客观有效率、疾病控制率、OS和PFS.同步放化疗后手术预期可能会改善患者OS.
목적 비교국부만기비소세포폐암(non-small cell lung cancer,NSCLC)동보방화료여서관방화료적료효.방법 회고성분석2002년3월지2012년10월북경협화의원수치적경병이학학진적초치국부만기NSCLC환자121례,근거치료방식분위동보방화료조(n=66)여서관방화료조(n=55).비교량조환자적객관료효、총생존기(overall survival,OS)화무진전생존기(progress-free survival,PFS).채용x2검험비교계수자료,t검험비교량양본균수,Kaplan-Meier방법비교OS화PFS.결과 121례국부만기NSCLC환자적중위OS화PFS분별위23.1개월화10.7개월.동보방화료조여서관방화료조적객관유효솔분별위45.5％화16.4％,질병공제솔분별위84.8％화61.8％,중위OS분별위33.4개월화19.7개월,중위PFS분별위12.7개월화9.8개월,량조간비교차이균유통계학의의(x2=10.128,P＜0.05).동보방화료후수술10례,중위OS화PFS균미체도.결론 동보방화료여서관방화료상비능명현제고국부만기NSCLC적객관유효솔、질병공제솔、OS화PFS.동보방화료후수술예기가능회개선환자OS.
Objective To compare the effectiveness of concurrent chemoradiotherapy and sequential chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).Methods From March 2002 to October 2012,121 patients with stage Ⅲ NSCLC in Peking Union Medical College Hospital were enrolled into concurrent chemoradiotherapy group and sequential chemoradiotherapy group.Objective response rate (ORR),overall survival (OS),and progression-free survival (PFS) were compared between two groups.Enumeration data were analyzed by Chi-Square test,the mean of samples by t-test,and OS and PFS by Kaplan-Meier test.Results Among 121 patients with stage Ⅲ NSCLC,66 patients received concurrent chemoradiotherapy and 55 patients received sequential chemoradiotherapy.The median OS and PFS of the whole group were 23.1 and 10.7 months.In concurrent chemoradiotherapy group and sequential chemoradiotherapy group,ORR was 45.5％ and 16.4％,the disease control rate (DCR) was 84.8％ and 61.8％,the median OS was 33.4 and 19.7 months,and the median PFS was 12.7 and 9.8 months,there were significant differences between two groups (x2 =10.128,P ＜0.05).In concurrent chemoradiotherapy group,ten patients received surgery after chemoradiotherapy.The median OS and PFS did not arrival.Conclusions Compared with sequential chemoradiotherapy,concurrent chemoradiotherapy can significantly increase the ORR,DCR,OS,and PFS for patients with locally advanced NSCLC.Surgery after concurrent chemoradiotherapy may prolong the survival in carefully selected patients.