Ⅰ、Ⅱ期老年非小细胞肺癌的放疗  

Radiotherapy for Elderly Patients with Stage Ⅰ～Ⅱ Non-Small Cell Lung Cancer

作　　者：杨焕军[1] 蒋国樑[1] 王丽娟[1] 赵森[1] 

机构地区：[1]上海医科大学肿瘤医院,200032

出　　处：《实用癌症杂志》2000年第3期300-302,共3页The Practical Journal of Cancer

摘　　要：目的　探讨Ⅰ、Ⅱ期老年非小细胞肺癌 (NSCLC)放疗的价值。方法　对 1991年 1月至 1996年 12月首次治疗 ,年龄≥ 70岁 ,KPS≥ 60 ,Ⅰ、Ⅱ期NSCLC 73例患者进行分析。所有病例均经细胞学或组织学证实。患者中位年龄为 72岁 ( 70～ 81岁 )。治疗方案为根治性放疗和手术治疗 ,放疗组 46例 ,手术组 2 7例。统计用Kaplan Meier法及Log rank检验。 结果　放疗组与手术组 5年生存率分别为 5 2 %和 5 3 % (P >0 .0 5 ) ;5年胸腔局部肿瘤控制率分别为 3 0 %和 3 4 % (P >0 .0 5 ) ;5年远处转移率分别为 69%和 5 0 % (P >0 .0 5 )。治疗的并发症和毒副作用 ,放疗组 :并发急性放射性肺炎 5例 ( 11% ,5 /46) ,其中Ⅰ、Ⅱ级 3例 ,Ⅲ级 2例 ;急性放射性食管炎 2 2例 ( 4 8% ,2 2 /46) ,其中Ⅰ、Ⅱ级 2 0例 ,Ⅲ级 2例。手术组 :发生并发症 7例 ( 2 6% ,7/2 7) ,其中心律失常 3例 ,呼吸衰竭 2例 ,肺炎 1例 ,应激性消化道溃疡 1例 ;2组无 1例死于并发症。结论　Ⅰ、Ⅱ期老年NSCLC采用手术与放射治疗的疗效无显著性差异。对老年Ⅰ、Ⅱ期NSCLC ,放疗是手术以外的 1个可选择的重要治疗方法。Objective To evaluate the effect of radiotherapy for elderly patients with stage Ⅰ,Ⅱ non small cell lung cancer(NSCLC).Methods Form January 1991 to December 1996,73 cases of age≥70 years old,KPS ≥60,and Ⅰ～Ⅱ stage who received surgery(27cases) or radical irradiation(RT,46 cases) were enrolled.Their survival rate、local control rate and distant metastasis rate were estimated by Kaplan Meier model and Log rank test.Results The data of RT and surgery group showed that the 5 year survival rate was 52% and 53%,respectively( P >0.05),5 year local control rate was 30% and 34%,respectively( P >0.05),5 year distant metastasis rate was 69% and 50%( P >0.05),respectively.The main side effects or complications in RT group were pneumonitis(5 cases) and radiation esophagitis(22 cases).In surgery group,complications occurred in 7 cases.There were no deaths related with complications in both group.Conclusion The differences in outcome between RT and surgery were no significant.Besides surgery,radiotherapy is another important treatment method for elderly patients with stage Ⅰ～Ⅱ NSCLC.

关 键 词：非小细胞肺癌 肺肿瘤 放射疗法 老年人 

分 类 号：R734.205[医药卫生—肿瘤] R730.44[医药卫生—临床医学]