摘要
目的探讨Ⅲ-Ⅳ期NSCLC同期放化疗后寡转移失败规律，思考局部放疗意义。方法分析2007-2014年229例初治Ⅲ-Ⅳ期NSCLC同期放化疗后寡转移等失败规律。结果299例NSCLC中Ⅲ期治疗失败88例，原发肿瘤复发±远处转移20例（22．7％）、寡转移27例（30．7％），脑转移最多见；Ⅳ期治疗后失败211例，原发肿瘤复发±远处转移11．4％、原转移灶复发10．0％、原转移器官出现新病灶9．0％，寡与非寡转移中原转移灶复发分别为9／94例和12／117例；脑转移发生率最高（38．2％）。结论Ⅲ期NSCLC寡转移失败近1／3，Ⅳ期仍10％表现为寡转移特征；脑转移是主要失败模式，Ⅳ期NSCLC原发肿瘤根治剂量放疗可降低局部复发失败。
Objective To investigate the failure patterns and oligometastasis after concurrent ehemoradiotherapy for stage Ⅲ-Ⅳ non-small cell lung cancer （ NSCLC ） , and to discuss the significance of local radiotherapy. Methods The patterns of failure including oligometastasis were analyzed in 299 previously untreated patients with stage Ⅲ-Ⅳ NSCLC who underwent concurrent chemoradiotherapy from 2007 to 2014. Results Of all the patients with NSCLC, 88 patients with stage Ⅲ NSCLC failed, among whom 22（ 22. 7% ） experienced primary tumor recurrence with or without distant metastasis and 27（ 30. 7% ） experienced oligometastasis, and brain metastasis was the most common failure pattern. A total of 211 patients with stage IV NSCLC failed, among whom 11.4% experienced primary tumor recurrence with or without distant metastasis, 10. 0% experienced recurrence of the primary metastatic lesions, and 9. 0% experienced new lesions in the organs with metastasis;9 out of 94 patients with oligometastasis and 12 out of 117 patients without oligometastasis, respectively, experienced recurrence of the primary metastatic lesions. Brain metastasis had the highest incidence rate （ 38. 2%）. Conclusions After concurrent chemoradiotherapy, nearly 1/3 patients with stage Ⅲ NSCLC and 10% patients with stage Ⅳ NSCLC experience the failure of oligometastasis, and brain metastasis is the most common pattena of failure. Radical radiotherapy for primary tumors in stage Ⅳ NSCLC can reduce local recurrence.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2016年第1期20-24,共5页
Chinese Journal of Radiation Oncology
基金
贵州省科技攻关项目[SY[2010]3078]
贵州省社发攻关资助项目[SY[2008]1001]
贵州省应用基础研究重大专项（黔科合J重大字[2015]2003）
关键词
癌
非小细胞/同期放化疗法
寡转移
失败分析
Cancer, non-small-cell/concurrent chemoradiotherapy
Oligometastases
Failure analysis
