PET—CT下三维适形放疗Ⅲ期非小细胞肺癌的预后分析  

Outcome and prognostic factors in stage Ⅲ non-small-cell lung cancer treated with definitive radiation therapy with

作　　者：宋颖秋[1] 王天禄[2] 党军[1] 陈延治[1] 裘敬平[1] 姚雷[1] 李光[1] 

机构地区：[1]中国医科大学附属第一医院放疗科,沈阳110001 [2]辽宁省肿瘤医院放疗科

出　　处：《中华放射肿瘤学杂志》2011年第5期390-393,共4页Chinese Journal of Radiation Oncology

基　　金：辽宁省科学技术计划项目（2006225007-5）

摘　　要：目的探讨在PET—CT指导下行三维适形放疗（3DCRT）的Ⅲ期非小细胞肺癌（NSCLC）的疗效和预后因素。方法对59例在PET—CT定位下行3DCRT的Ⅲ期NSCLC患者，采用Kaplan—Meier法计算生存率并Logrank法检验和单因素预后分析，对单因素分析有意义的因素进一步行Cox模型多因素预后分析。结果随访率为98％，随访满2年者为19例。1、2年生存率分别为66％、37％，中位生存期17个月。单因素分析结果显示影响预后的因素有吸烟、放疗剂量、大体肿瘤体积、SUV值、T分期、临床分期（X^2=7．46、7．52、8．37、4．97、5．82、4．37，P=0．006、0．006、0．004、0．026、0．016、0．037）。Cox模型多因素分析显示影响预后的因素有吸烟、放疗剂量、大体肿瘤体积、临床分期（X^2=6．20、9．69、6．39、10．09，P=0．013、0．002、0．011、0．001）。结论PET—CT定位下行3DCRT的Ⅲ期NSCLC患者的生存时间优于以往报道，吸烟、放疗剂量、大体肿瘤体积、临床分期是影响生存的因素。Objective To investigate prognostic factors in Stage Ⅲ non-small cell lung cancer （NSCLC） treated with definitive radiation therapy （RT） with PET-CT-based radiotherapy planning. Methods Fifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study. The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98%. Nineteen patients completed 2 years＇ followed-up. The overall 1-year and 2-year survival rate was 66% and 37% , respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors （X^2 = 7.46,7.52,8.37,4.97,5.82,4. 37,P = 0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively）. At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors （ X^2 = 6. 20, 9.69, 6. 39, 10.09, P = 0. 013,0. 002, 0. 011,0. 001, respectively）. Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.

关 键 词：体层摄影术 正电子发射 癌 非小细胞肺/放射疗法 放射疗法 三维适形 预后 

分 类 号：R734.2[医药卫生—肿瘤]