摘要
目的分析非小细胞肺癌（NSCLC）术后接受三维适形放射治疗（3DCRT）的初步结果。方法84例NSCLC患者术后接受3DCRT，其中肺叶切除65例（77．4％），全肺切除19例（22．6％）；完整的R0切除54例（64．3％），镜下切缘阳性的R1切除15例（17．9％），肉眼残存的R2切除15例（17．9％）。术后病理分期为ⅠB期1例，ⅡB期7例，ⅢA期52例，ⅢB期24例。全组术后中位放疗剂量为60Gy（40～70Gy，2Gy／次）。术后37例患者接受中位3个周期的辅助化疗。中位随访时间为35．5个月。结果全组患者的3年生存率为58．6％，4年生存率为43．9％。有43例（53．1％）出现复发转移，其中胸内复发8例（9．9％），远处转移38例（46．9％）。单因素分析显示，患者性别、年龄、体重下降、肿瘤大小、病理类型和分期与预后无关。接受R1、R2切除的患者预后较差。随访中，有9例（11．1％）患者出现2级以上放射性肺炎。结论NSCLC患者术后采用3DCRT放疗效果较好，不良反应发生率较低，安全可靠。
Objective To investigate the association between survival and postoperative three- dimensional conformal radiotherapy （3DCRT） in patients with resected non-small cell lung cancer （NSCLC）. Methods Eighty-four patients were treated with surgery and postoperative 3DCRT for NSCLC. Sixty-five （77.4%） patients received lobectomy, and 19 （22.6%） received pneumonectomy. Fifty-four （64.3%） patients achieved R0 resection and 30 cases （35. 8% ） received R1/R2 resection. Fifty-two patients were of stage ⅢA and 24 patients were of stage ⅢB. Photon energy of 6 MV was used for all the patients. The median 3DCRT dose was 60 Gy （40-70 Gy） with a fraction size of 2 Gy. Thirty-seven patients received median 3 cycles of adjuvant chemotherapy. The median follow-up was 35.5 months for survivors. Results The overall 3-year survival rate was 58.6% , and the 4-year overall survival rate was 43.9%. Of the 43 patients who had treatment failure, only 8 （9.9%） patients showed intrathoracic recurrence, but 38 （46.9%） patients had distant metastasis. The univariate analysis for all patients showed that sex, age, weight loss, tumor size, pathology and stage were not correlated with prognosis. R1/R2 resection was associated with a significantly worse survival. Toxicities were acceptable, with 9 （11. 1% ） patients appeared higher than NCI CTC grade 2 radiation pneumonitis. Conclusion In a population-based cohort, postoperative 3DCRT for NSCLC provides a good prognosis, and the radiation-related pneumonitis is acceptable.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2008年第10期783-786,共4页
Chinese Journal of Oncology
关键词
肺肿瘤
放射疗法
三维适形
预后
Lung neoplasms
Radiotherapy
Three-dimensional conformal
Prognosis
