ⅢB期非小细胞肺癌手术及综合治疗的价值  

Surgery and Combined Treatment for Stage ⅢB Non-small Cell Lung Cancer

作　　者：曹霞[1] 杨式滔[1] 

机构地区：[1]湖南省肿瘤医院放疗科,410006

出　　处：《实用癌症杂志》2001年第6期631-633,共3页The Practical Journal of Cancer

摘　　要：目的　探讨ⅢB期非小细胞肺癌手术及综合治疗的价值。方法　将 1987年 1月～ 1993年 7月收治的并经病理证实的Ⅲ期非小细胞肺癌 98例分成 3组 :A组 30例ⅢA期患者行手术及综合治疗 ;B组 34例ⅢB期患者行手术及综合治疗 ;C组 34例ⅢB期患者行非手术治疗。结果　B组无心肺并发症及死亡。B、C组 2年生存率分别为 31.9%、12 .9% (P <0 .0 5 ) ,A、B、C组 5年生存率分别为 13.9%、9.6 %、6 .2 %。A、B 2组中Ⅲ期术后残端阳性与术后残端阴性患者 2年生存率分别为 12 .5 %、36 .2 % (P<0 .0 5 )。B组肿块≥ 8cm的 9例中有 2例生存期超过 5年 ,中位生存时间为 2 0 .9个月 ,此 9例中鳞癌占 6 6 .7% ( 6 / 9)。结论　对无恶性胸腔积液及非N3 的ⅢB期非小细胞肺癌患者 ,特别是对肿瘤≥ 8cm且为鳞癌的患者选择手术及综合治疗 ,不会增高术后心肺并发症死亡率 ,且比放疗、化疗的疗效好。Ⅲ期术后残端阳性者 ,尤其是单纯手术治疗者预后差。Objective To evaluate the value of surgery and combined treatment for stage ⅢB non-small cell lung cancer(NSCLC).Methods 98 cases of pathologicaly comfired stage Ⅲ NSCLC,between Jan 1987 to July 1993,were divided into 3 groups.30 cases of stage ⅢA NSCLC received surgery and combined treatment(Group A).34 cases of stage ⅢB NSCLC received same treatment(Group B).34 cases of stage ⅢB NSCLC received combined treatment but without surgery(Group C).Results None in Group B died of cardiopulmonary complication.The 2-year survival rates for Group B and C were 31.9%,12.9%(P<0.05) respectively.The 5-year survival rate of group A?B and C were 13.9%?9.6% and 6.2% respectively.The 2-year survival rates in group A and B with positive and negative remnants were 12.5%?36.2%(P<0.05) respectively.2 of 9 cases with a tumor dimentions above or equal to 8 cm in Group B survived more than 5 years.The median survival time was 20.9 months.Among the cases squamous cancer occupied for 66.7%(6/9).Conclusion For stage ⅢB NSCLC of non-N_3 and without malignant plural effusion,particularly the squamous cancer above or equal to 8 cm,surgery and combined treatment should be selected.They can't add mortality of cardiopulmonary complication,and will be more effective than only adopt radiotherapy and chemotherapy.Stage Ⅲ patients with positive remnants,especially those treated only with surgery have poorer prognosis.

关 键 词：非小细胞肺癌 外科治疗 综合治疗 治疗 手术方式 

分 类 号：R734.2[医药卫生—肿瘤]