影响非小细胞肺癌放疗局部控制的临床因素分析  

Analysis of factors affecting the local control of non small cell lung cancer treated by radiation therapy

作　　者：陈明[1] 傅小龙[1] 蒋国梁[1] 王丽娟[1] 钱浩[1] 赵森[1] 

机构地区：[1]上海医科大学附属肿瘤医院

出　　处：《上海医学》1998年第10期560-563,共4页Shanghai Medical Journal

摘　　要：目的：回顾性分析根治性放疗的非小细胞肺癌（ｎｏｎ－ｓｍａｌｃｅｌｌｕｎｇｃａｎｃｅｒＮＳＣＬＣ）病例，探讨影响放射治疗ＮＳＣＬＣ局部控制的因素。方法：选择１９９０年１月～１９９６年１２月间根治性放疗的经病理确诊的Ⅰ－Ⅲｂ期ＮＳＣＬＣ患者２５６例，局部控制统计采用Ｋａｐｌａｎ－Ｍｉｅｒｅ法及Ｌｏｇ－ｒａｎｋ检验，多因素分析采用Ｃｏｘ逐步回归模型。以多因素分析时各因素的变异系数乘以分组值计算预后指数。结果：全组中位局部控制时间９．７个月，１、３、５年局部控制率分别为５４％、２４％和１９％。单因素和多因素分析均显示肿瘤体积小、临床分期早、在较短的总疗程时间内接受较高剂量照射的患者局部控制率较高。综合以上３种因素的预后指数模型能够较好地区分不同的局控亚组。结论：肿瘤体积、临床分期、放疗方法是放射治疗ＮＳＣＬＣ局部控制的独立预后因素。Objective:A retrospective analysis was carried out to evaluate the factors affecting the local control of non small cell lung cancer (NSCLC) by radiotion therapy .Methods:From Jan.1990 to Dec. 1996, the eqqicacy of radiation therapy in 256 patients with stages Ⅰ Ⅲb NSCLC were analyged. All patients received radical radiotherapy.The significance of prognostic variables in the local control was evaluated using univariate analysis and Cox stepwise regression model.The prognostic index was calculated according to the value of each prognostic factor on survival.Results:The median valueq local control of whole group was 9.7 months,and the rate of control at 1,3 and 5 years were 54%,24% and 19%,respectively.Univariate and multivariate analysis showed patients with smaller tumor sige,earlier clinical staging and higher total radiation dose during a shorter period had better local control.Conclusion:Tumor volume,Clinical staging and radiotherapeutic method were independent prognostic factors.Prognostic index model could predict more effectively than single variable such as TNM staging.

关 键 词：非小细胞肺癌 肺肿瘤 放射疗法 局部控制 

分 类 号：R734.205[医药卫生—肿瘤] R730.55[医药卫生—临床医学]