Ⅳ期NSCLC同期放化疗单中心前瞻性生存分析  

Prospective survival analysis from a single center for stage Ⅳ NSCLC patients treated with chemotherapy and radiotherapy

作　　者：欧阳伟炜[1,2] 卢冰[1,2] 胡银祥[1,2] 苏胜发[1,2] 龙金华[1,2] 王刚[1,2] 栗蕙芹[1,2] 张波[3] 

机构地区：[1]贵阳医学院附属医院 [2]贵州省肿瘤医院肿瘤科,贵州贵阳550004 [3]安顺市人民医院肿瘤科,贵州安顺561000

出　　处：《中华肿瘤防治杂志》2013年第16期1262-1266,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：贵州省科技攻关项目〔黔科合SY(2010)3078〕

摘　　要：目的:探讨Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗同期胸部三维放疗的总体治疗获益对生存的影响。方法:入组的201例Ⅳ期NSCLC患者,19例为1个周期化疗,11例未评价化疗疗效,共30例不纳入生存分析。全组可评价171例,中位年龄59岁;化疗以铂类药物为基础二药联合方案,中位周期数4个;原发肿瘤计划靶区剂量(PTVDT)中位剂量为63Gy,范围9～72Gy。结果:171例总体治疗有效112例比无效59例、治疗获益144例比进展27例的生存期显著延长,P<0.001。治疗获益PTVDT≥63Gy与其他各剂量组比较生存期显著延长,P=0.016;4～5个周期治疗获益PTVDT≥63Gy,比PTVDT<63Gy生存率显著提高,P=0.005;化疗无效同期PTVDT≥63Gy比<63Gy生存率显著提高,P=0.005。Cox多因素回归分析结果显示,治疗获益和PTVDT≥63Gy是影响生存的预后因素,P值分别为<0.001和0.007。结论:Ⅳ期NSCLC化疗同期胸部三维放疗获益和提高照射剂量可以改善生存率。OBJECTIVE： To evaluate the impact of concurrent chemotherapy and thoracic three-dimensional radio- therapy on the overall survival with the treatment profit patients in stage IV non-small cell lung cancer （NSCLC）. METH- ODS：Totally 201 patients with stage IV （UICC stage 2002） NSCLC were recruited. Thirty patients were excluded for survival analysis, which included 19 patients who received one cycle chemotherapy only and 11 patients without obtainable data for treatment outcome evaluation. The number of evaluable patients were 171 and with median age of 59. Platinum based two drug regimen was used and median cycles were 4. The dose of radiotherapy for the planning target volume （DTPTV） on primary tumor was 9--72 Gy （median was 63 Gy）. RESULTS： There was a significant improvement on sur- vival time in the group of response patients or treatment profit patients

关 键 词：Ⅳ期非小细胞肺癌 同期化放疗 三维适形调强放疗 治疗获益 生存 

分 类 号：R734.2[医药卫生—肿瘤]