非小细胞肺癌淋巴结转移时间对患者生存率影响分析  

The effect on survival rate in non small cell lung cancer patients with lymph node metastasis of newly diagnosed and during treatment patients

作　　者：肖庆龄[1] 孙德彬[2] 洪群英[3] 江涛[3] 

机构地区：[1]江苏省中西医结合医院呼吸科,江苏南京210028 [2]丽水市中心医院呼吸科,浙江丽水323000 [3]复旦大学附属中山医院肺肿瘤中心,上海200032

出　　处：《临床肺科杂志》2010年第8期1075-1077,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的评价非小细胞肺癌患者淋巴结转移出现于初诊前或治疗中对患者生存率的影响。方法 80例未手术非小细胞肺癌(NSCLC)患者,卡氏评分≥70分,按初诊时有无淋巴结转移分为两组,初诊有淋巴结转移40例,归为同步淋巴结转移组,中位年龄50岁;治疗中或治疗后出现淋巴结转移40例,归为非同步淋巴结转移组,中位年龄55岁。两组患者皆行序贯放化疗,放疗范围包括病灶、纵隔及出现转移的颈部淋巴结区,总剂量Dt5000～6400cGy(中位剂量6000cGy),常规分割,预防性照射病侧锁骨上淋巴结区,单侧锁骨上淋巴结区转移者预防性照射对侧锁骨上淋巴结区。化疗方案采用NP和(或)TP方案。放疗后均继续化疗直至完成至少4个周期的化疗。结果同步淋巴结转移组平均生存时间为13月,非同步组平均生存时间为16月(P=0.020)。非同步组出现淋巴结转移至死亡的平均时间为7月(P<0.01)。结论对于未手术的NSCLC患者来说,发生淋巴结转移,从出现淋巴结转移至死亡的生存时间同步较非同步者长。Objective To evaluatetheeffectonsurvivalrateinnon smallcelllungcancer（NSCLC） patientswith lymphnodemetastasis of newly diagnosed and during treatment patients.Methods 80 cases of non-surgical treatment NSCLC patients were divided into two groups.There were 40 cases of lymph node metastasis in newly diagnosed patients,classified as synchronous lymph node metastasis,with a median age of 50 years old;and there were 40 cases without metastasis in the beginning but occurred lymph node metastasis during and after chemo and radio therapy patients,classified as non-synchronous group,the median age was 55 years old.Both groups all received sequential radiotherapy and chemotherapy,including the scope of radiation of tumor lesions,mediastinal and lymph node metastasis in the neck area,a total dose Dt 5000 ～ 6400 cGy（median dose 6000 cGy）,conventional fractionation,preventive irradiation supraclavicular lymph node area of disease side,preventive irradiation contralateral supraclavicular lymph node area of patients with unilateral supraclavicular lymph node metastasis.Chemotherapy was with NP and TP program.After radiotherapy,chemotherapy continued at least until the completion of four cycles of chemotherapy.Results The average survival time of synchronous lymph node metastasis group was 13 months.Mean survival time from diagnosis to death of the non-synchronous group was 7 months（P 〈0.01）.Conclusion The average survival time from diagnosis of lymph node metastasis to death,the synchronous lymph node metastasis group is significantly longer than the nonsynchronous group for non surgical treatment NSCLC patients.Compared with the non-synchronous group,the average survival time from diagnosis of lymph node metastasis to death in the synchronous group is significantly longer in the non surgical treatment of NSCLC patients.

关 键 词：未手术 非小细胞肺癌 淋巴结转移 放化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]