111例Ⅲ期胸腺瘤治疗结果分析
111례Ⅲ기흉선류치료결과분석
Analysis of treatment outcome for stage Ⅲ thymoma
  • 万方数据
    中华放射肿瘤学杂志 중화방사종류학잡지
    CHINESE JOURNAL OF RADIATION ONCOLOGY
    2012年 6期 513-517 ,共5页

    范诚诚%冯勤付%毛友生%陈怡东%翟医蕊%张红星%陈东福%肖泽芬%李鉴%周宗玫%梁军%吕纪马%惠周光%王绿化%赫捷

    범성성%풍근부%모우생%진이동%적의예%장홍성%진동복%초택분%리감%주종매%량군%려기마%혜주광%왕녹화%혁첩

    胸腺肿瘤/外科学%胸腺肿瘤/放射疗法%综合疗法%治疗结果 胸腺腫瘤/外科學%胸腺腫瘤/放射療法%綜閤療法%治療結果
    흉선종류/외과학%흉선종류/방사요법%종합요법%치료결과
    Thymus neoplasms/surgery%Thymus neoplasms/radiotherapy%Combined modality therapy%Treatment outcome
    目的 分析Ⅲ期胸腺瘤的生存和复发情况及影响预后因素.方法 回顾分析1965-2010年间本院首次治疗的111例MasaokaⅢ期胸腺瘤患者临床资料,其中根治术±放疗68例,姑息术±放疗23例,活检术±放疗20例.单纯手术24例,术后放疗87例中12例术前放疗.结果 中位随访时间66个月,随访率为92.5％,随访时间满5年者60例.根治术比姑息术和活检术的5年总生存率(OS)、无瘤生存率(DFS)、肿瘤特异生存率(DSS)均高[(88％比59％和57％,x2=12.11,P=0.002)、(74％比40％和41％,x2=11.49,P =0.003)、(94％比69％和60％,x2=10.95,P=0.004)],全组单纯手术与术后放疗的生存相似[55％与77％(x2=1.01,P=0.316)、61％与61％ (x2 =0.12,P =0.729)、72％与85％(x2=0.27,P=0.601)],68例根治术±放疗中,单纯手术(12例)与术后放疗(56例)生存也相似[82％与89％(x2=0.31,P=0.576)、72％与81％(x2=0.05,P=0.819)、89％与95％(x2 =0.05,P=0.825)].结论 Ⅲ期胸腺瘤首选根治性手术,疗效优于姑息术和单纯活检者,应开展多中心临床随机研究以明确术后辅助放疗的作用.
    목적 분석Ⅲ기흉선류적생존화복발정황급영향예후인소.방법 회고분석1965-2010년간본원수차치료적111례MasaokaⅢ기흉선류환자림상자료,기중근치술±방료68례,고식술±방료23례,활검술±방료20례.단순수술24례,술후방료87례중12례술전방료.결과 중위수방시간66개월,수방솔위92.5％,수방시간만5년자60례.근치술비고식술화활검술적5년총생존솔(OS)、무류생존솔(DFS)、종류특이생존솔(DSS)균고[(88％비59％화57％,x2=12.11,P=0.002)、(74％비40％화41％,x2=11.49,P =0.003)、(94％비69％화60％,x2=10.95,P=0.004)],전조단순수술여술후방료적생존상사[55％여77％(x2=1.01,P=0.316)、61％여61％ (x2 =0.12,P =0.729)、72％여85％(x2=0.27,P=0.601)],68례근치술±방료중,단순수술(12례)여술후방료(56례)생존야상사[82％여89％(x2=0.31,P=0.576)、72％여81％(x2=0.05,P=0.819)、89％여95％(x2 =0.05,P=0.825)].결론 Ⅲ기흉선류수선근치성수술,료효우우고식술화단순활검자,응개전다중심림상수궤연구이명학술후보조방료적작용.
    Objective To analyze survival and recurrence rates of patients with Masaoka stage Ⅲ thymoma and to explore the prognostic factors.Methods Between September 1965 and December 2010,a total of 111 patients with stage Ⅲ thymoma treated in our hospital were retrospectively analyzed.Sixty-eight patientsreceived comple te rescction ± radiotherapy,whilc 23 patients received incomplete resection ±radiotherapy and 20 patients received biopsy ± radiotherapy.Eighty-seven patients received postoperative radiotherapy (12 patients received preoperative radiotherapy) while 24 patients received surgery alone.Results The median follow-up time was 66 months (5-540) with a follow-up rate of 92.5％ (111/120).Compared with incomplete resection ± radiotherapy and biopsy ± radiotherapy,the 5-year overall survival (OS) (88％ vs.59％ and 57％,x2 =12.11,P =0.002),disease free survival (DFS) (74％ vs.40％ and 41％,x2 =11.49,P =0.003) and disease specific survival (DSS) (94％ vs.69％ and 60％,x2 =10.95,P =0.004) could be improved with complete resected ± radiotherapy.Compared with surgery alone,postoperative radiotherapy did not improve OS,DFS and DSS (55％ vs.77％ (x2 =1.01,P =0.316),61％vs.61％ (x2 =0.12,P =0.729) and 72％ vs.85％ (x2 =0.27,P =0.601),respectively).For the 68 patients received complete resection,radiotherapy after complete resection (56 patients) did not improve OS,DFS and DSS (82％ vs.89％ (x2 =0.31,P =0.576),72％ vs.81％ (x2 =0.05,P=0.819) and 89％vs.95 ％ (x2 =0.05,P =0.825),respectively) compared with surgery alone (8 patients).Conclusions Stage Ⅲ thymoma patients received complete resection had better outcome than patients received incomplete resection or biopsied only.The role of postoperative radiotherapy is still controversial for stage Ⅲ thymoma,randomized clinical trial is needed
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