非小细胞肺癌患者术后单纯区域淋巴结复发的治疗及预后影响因素分析  

Survival after regional lymph node recurrent of non-small cell lung cancer after complete pulmonary resection

作　　者：邓清华[1] 盛李明[1] 卢珂[1] 刘鹏[1] 

机构地区：[1]浙江省肿瘤医院放疗科,浙江杭州310029

出　　处：《中国癌症杂志》2011年第6期465-469,共5页China Oncology

摘　　要：背景与目的:术后局部淋巴结复发是非小细胞肺癌(non-small cell lung cancer,NSCLC)治疗失败的主要原因之一。本研究旨在探讨NSCLC患者术后单纯区域淋巴结复发的治疗选择和预后影响因素。方法:收集2000年—2009年143例NSCLC术后单纯区域淋巴结复发的患者,回顾性分析临床、病理因素以及不同治疗方式对复发后生存的影响。结果:126例患者发生同侧胸腔区域淋巴结复发,17例发生对侧胸腔区域淋巴结复发;复发后51例患者接受了放化疗联合治疗,27例单纯放疗,59例单纯化疗;单因素、多因素分析显示复发时患者PS评分、复发部位、复发病灶数目以及手术至复发的间隔时间均为独立预后因素;在64例术后1年以上复发患者中,放化疗联合治疗中位生存期为62个月,而单纯放疗或单纯化疗的中位生存期仅为24个月,放化疗联合治疗与单纯放疗和单纯化疗患者生存曲线差异有统计学意义(P<0.05)。结论:复发时患者PS评分高、同侧胸腔外淋巴结复发、多个复发病灶以及术后1年以内复发患者预后不佳,对于手术后1年以上复发患者采用放化疗联合治疗能获得更长的生存期。Background and purpose:Postoperative regional lymph node recurrence is a major obstacle to achieve a cure and long-term survival in patients with non-small cell lung cancer(NSCLC).This study aimed to investigate the prognostic factors and treatment choice for regional lymph node recurrence in NSCLC after resection.Methods:Patients with complete resection with systematic lymph node dissection for non-small cell lung cancer were selected.A total of 143 patients were retrospectively reviewed.Results:The recurrent site was ipsilateral thorax in 126 patients and the contralateral thorax in 17 patients.Chemoradiothrapy was performed in 51 patients,while radiotherapy in 27 patients,chemotherapy in 59 patients.Prognostic analysis of factors demonstrated that PS score,recurrence site,number of recurrent foci and time to recurrence were signi?cant prognostic factors in both univariate and multivariate analysis.Median survival after recurrence was 62 months and 24 months in patients treated with chemoradiothrapy and single modality treatment in 64 patients with time to recurrence more than 1 year.There were statistically significant differences among these two groups(P<0.05).Conclusion:High PS score,supraclavicular or contralateral thorax recurrence,multiple recurrent foci and time to recurrence less than 1 year were worse prognostic factors.Chemoradiotherapy for the patients with time to recurrence more than 1 year may prolong survival after recurrence.

关 键 词：非小细胞肺癌 复发 区域淋巴结 预后因素 

分 类 号：R73[医药卫生—肿瘤]