肺类癌的治疗与预后  

Treatment and prognosis of pulmonary carcinoid tumors

作　　者：高远红[1] 肖泽芬[1] 王绿化[1] 刘新帆[1] 李晔雄[1] 徐国镇[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2001年第3期162-165,共4页Chinese Journal of Radiation Oncology

摘　　要：目的　总结肺类癌的临床特点、治疗方法及疗效 ,评价影响预后的因素。方法　回顾性分析 2 5例肺类癌的临床资料。其中典型类癌 (TC) 16例 ,非典型类癌 (AC) 9例。根据 1997年国际抗癌联盟分期 ,Ⅰ期 15例 (TC 14例 ,AC 1例 ) ,Ⅱ期 4例 (TC 1例 ,AC 3例 ) ,Ⅲ期 6例 (TC 1例 ,AC 5例 )。 2 5例患者均手术治疗 ,其中 18例行单纯手术治疗 ,5例行术后放射治疗 ,2例行术后化疗。结果　全组 5年和 10年生存率分别为 87%和 72 % ,单纯手术治疗患者 5年生存率为 93% ,术后辅助治疗的患者无 1例生存超过 5年。典型类癌的 5年生存率为 10 0 % ,而非典型类癌为 38%。Ⅰ期 5年生存率为 10 0 %、Ⅱ +Ⅲ期为 5 3%。单因素分析示病理类型和分期均为有显著性意义的预后因素。结论　肺类癌以手术治疗为主 ,对于Ⅲ期肺非典型类癌 ,推荐术后行辅助性化疗和 (或 )放射治疗。多数肺类癌患者可获得长期生存 。Objective To evaluate the clinical characteristics, treatment and prognosis of lung carcinoid tumors. Methods Twenty five patients with lung carcinoid tumors were retrospectively reviewed. Sixteen patients were confirmed pathologically as having typical carcinoid (TC) and 9 atypical carcinoid (AC). According to 1997 UICC staging system, 15 were classified as stage Ⅰ (TC 15 , AC 1 ), 4 stage Ⅱ (TC 1 , AC 3 ) and 6 stage Ⅲ (TC 1, AC 5 ). All patients received surgery. Eighteen patients were treated by surgery alone, 5 by surgery plus postoperative radiotherapy and two by surgery plus postoperative chemotherapy. Results The overall 5 and 10 year survivals were 87% and 72%, respectively. The 5 year survival rate was 93% for surgery alone but none of the 7 patients by surgery plus radiotherapy or chemotherapy survived for more than 5 years. The overall 5 year survival was 100% for stage Ⅰ and 53% for stage Ⅱ/Ⅲ. The corresponding survival was 100% for TC and 38% for AC,respectively. Univariate analysis showed that pathological type and stage were the significant prognostic factors. Conclusions Surgery has remained the primary treatment for lung carcinoid tumors. Postoperative radiation and/or chemotherapy should be considered for those patients with stage Ⅲ or atypical carcinoid tumors. Long term survival can be obtained in most patients. The pathology and stage are important prognostic factors.

关 键 词：肺类癌 放射治疗 预后因素 生存率 外科手术 临床特点 

分 类 号：R734.2[医药卫生—肿瘤]