肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2013年
7期
469-471,474
,共4页
癌,非小细胞肺癌%放射疗法%肿瘤转移,纵隔淋巴结%放疗靶区
癌,非小細胞肺癌%放射療法%腫瘤轉移,縱隔淋巴結%放療靶區
암,비소세포폐암%방사요법%종류전이,종격림파결%방료파구
Carcinoma,non-small-cell lung%Radiotherapy%Neoplasm metastasis,mediastinal lymph node%Target volumes
目的 分析非小细胞肺癌(NSCLC)纵隔淋巴结转移规律,探讨NSCLC放射治疗靶区的勾画范围.方法 对291例NSCLC患者治疗前行纵隔CT增强扫描,分析纵隔各分区淋巴结转移的发生率,探索NSCLC纵隔淋巴结转移发生的规律.结果 152例右肺NSCLC患者中发生同侧锁骨上淋巴结转移24例,发生率15.8％,对侧锁骨上淋巴结转移10例,发生率6.6％,纵隔淋巴结转移率最高的是同侧肺门淋巴结,为59.2％,其次为4R区(56.6％)、1～2R区(36.2％)、7区(33.6％)、4L区(20.4％)、10～11L区(5.9％)、6区(3.9％)、5区(2.0％)、1～2L区(2.0％),左肺NSCLC 139例中发生同侧锁骨上淋巴结转移22例,发生率15.8％,对侧锁骨上淋巴结转移8例,发生率5.8％,纵隔淋巴结转移率最高的也是同侧肺门淋巴结,为54.0％,其次是7区(33.8％)、4R区(26.6％)、4L区(24.5％)、1～2R区(15.8％)、5区(10.8％)、6区(9.4％)、1～2L区(5.8％)、10～11R区(5.0％).结论 左右肺叶NSCLC具有不同高危纵隔淋巴结转移区域,对这些高危区域进行选择性预防照射,有助于降低复发率,提高局部控制率.
目的 分析非小細胞肺癌(NSCLC)縱隔淋巴結轉移規律,探討NSCLC放射治療靶區的勾畫範圍.方法 對291例NSCLC患者治療前行縱隔CT增彊掃描,分析縱隔各分區淋巴結轉移的髮生率,探索NSCLC縱隔淋巴結轉移髮生的規律.結果 152例右肺NSCLC患者中髮生同側鎖骨上淋巴結轉移24例,髮生率15.8％,對側鎖骨上淋巴結轉移10例,髮生率6.6％,縱隔淋巴結轉移率最高的是同側肺門淋巴結,為59.2％,其次為4R區(56.6％)、1～2R區(36.2％)、7區(33.6％)、4L區(20.4％)、10～11L區(5.9％)、6區(3.9％)、5區(2.0％)、1～2L區(2.0％),左肺NSCLC 139例中髮生同側鎖骨上淋巴結轉移22例,髮生率15.8％,對側鎖骨上淋巴結轉移8例,髮生率5.8％,縱隔淋巴結轉移率最高的也是同側肺門淋巴結,為54.0％,其次是7區(33.8％)、4R區(26.6％)、4L區(24.5％)、1～2R區(15.8％)、5區(10.8％)、6區(9.4％)、1～2L區(5.8％)、10～11R區(5.0％).結論 左右肺葉NSCLC具有不同高危縱隔淋巴結轉移區域,對這些高危區域進行選擇性預防照射,有助于降低複髮率,提高跼部控製率.
목적 분석비소세포폐암(NSCLC)종격림파결전이규률,탐토NSCLC방사치료파구적구화범위.방법 대291례NSCLC환자치료전행종격CT증강소묘,분석종격각분구림파결전이적발생솔,탐색NSCLC종격림파결전이발생적규률.결과 152례우폐NSCLC환자중발생동측쇄골상림파결전이24례,발생솔15.8％,대측쇄골상림파결전이10례,발생솔6.6％,종격림파결전이솔최고적시동측폐문림파결,위59.2％,기차위4R구(56.6％)、1～2R구(36.2％)、7구(33.6％)、4L구(20.4％)、10～11L구(5.9％)、6구(3.9％)、5구(2.0％)、1～2L구(2.0％),좌폐NSCLC 139례중발생동측쇄골상림파결전이22례,발생솔15.8％,대측쇄골상림파결전이8례,발생솔5.8％,종격림파결전이솔최고적야시동측폐문림파결,위54.0％,기차시7구(33.8％)、4R구(26.6％)、4L구(24.5％)、1～2R구(15.8％)、5구(10.8％)、6구(9.4％)、1～2L구(5.8％)、10～11R구(5.0％).결론 좌우폐협NSCLC구유불동고위종격림파결전이구역,대저사고위구역진행선택성예방조사,유조우강저복발솔,제고국부공제솔.
Objective To explore the reasonable clinical target volumes by analyzing the characteristic of mediastinal lymph node metastases in non-small-cell lung cacer (NSCLC).Methods 291 NSCLC patients was performed pre-therapy CT scans,and the incidence of mediastinal lymph node metastases was analysed.Results Among the 152 patients with right lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (24/152),and the incidence of involvement of the contralateral lymph nodes was 6.6 ％ (10/152).The highest incidence of mediastinal nodal involvement occurred in the ipsilateral hilar nodes (59.2 ％),followed by area 4R (56.6 ％),area 1-2R (36.2 ％),area 7 (33.6 ％),area 4L(20.4 ％),area 10-11L (5.9 ％),area 6 (3.9 ％),area 5 (2.0 ％),area 1-2L (2.0 ％),respectively.Among the 139 patients left lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (23/139),and the incidence of involvement of the contralateral lymph nodes was 5.8 ％ (8/139).The highest incidence of mediastinal nodal involvement occurred also in the ipsilateral hilar nodes (54.0 ％),followed by area 7 (33.8 ％),area 4R (26.6 ％),area 4L (24.5 ％),area 1-2R (15.8 ％),area 5 (10.8 ％),area 6 (9.4 ％),area 1-2L (5.8 ％),area 10-11R (5.0 ％) respectively.Conclusion The right side primaries or left side primaries of NSCLC have different high risk lymph node areas for metastasis,and selective irradiation to these lymph node areas maybe increase the tumor control rate and reduce the recurrence rate.
