摘要
目的回顾分析肿瘤体积对ⅢA期和ⅢB期非小细胞肺癌患者三维立体适形放疗预后的影响。方法 2002～2009年间64例患者入组分析。23例采用单独放疗、23例采用同步放化疗、18例序贯放化疗。放疗的中位剂量是60(50～78)Gy。结果全组1、3、5年总生存率和中位生存期分别是69.7%,22.7%和10.4%,18.6个月,1、3、5年肿瘤专项生存率依次为73.8%,29.7%和15.8%。单因素分析提示近期疗效、纵隔淋巴结预防照射、放疗总剂量、肿瘤体积与总生存率及肿瘤专项生存率有显著相关性;多因素分析表明肿瘤体积和近期疗效是总生存及肿瘤专项生存的最重要的影响因素。评价预后的最佳肿瘤体积分界值可能是80cm3。结论三维立体适形放疗治疗不能手术的局部晚期非小细胞肺癌时,肿瘤体积和近期疗效是显著影响总生存和肿瘤专项生存的两个因素。80cm3可能是影响预后的最佳肿瘤体积分界点。
Objective To evaluate tumor volume impact on patient prognosis with stageⅢ A and stageⅢB NSCLC treated by three dimensional confornlal radiation therapy （3D CRT）.Methods Between 2002 and 2009,64 cases were analyzed.23 patients were treated with radiotherapy alone;23 patients were treated with concurrent chemoradiotherapy;18 patients were treated with sequential chemoradiotherapy.The median radiotherapy dose were 60 （range 50-78） Gy.Results For the whole group,median survival time was 18.6 months.1,3,5 year overall survival rates （OS） were 69.7%,22.7%,10.4%;1,3,5-year cancer specific survival rates （CSS） were 73.8%,29.7%,15.8%.In univariate analysis,the following variables were significantly associated with OS and CSS：elected node irradiation,total dose,tumor volume and clinical tumor response.In multivariate analysis,tumor volume and clinical tumor response were the independent factors on OS and CSS.80 cm3 of tumor volume was selected as the threshold which optimally predict the prognosis.Conclusion Tumor volume of 80 cm3 is the threshold which optimally predicts the prognosis for patients with StageⅢ A and stageⅢB NSCLC patients who are treated by 3D CRT.Tumor volume and clinical tumor response are independent factors on OS and CSS.
出处
《中国当代医药》
2012年第13期59-61,共3页
China Modern Medicine
关键词
局部晚期非小细胞肺癌
三维立体适形放疗
肿瘤体积界值
预后
Locally advanced non-small-cell lung cancer
Three-dimensional radiotherapy
The threshold of tumor volume
