术后放疗在T1-2 N0 M0期SCLC治疗中的意义  

Significance of postoperative radiotherapy in treatment of stage T1-2 N0 M0 small - cell lung cancer

作　　者：刘维帅[1] 赵路军[2] 张宝忠[2] 巩琳琳[2] 关勇[2] 王平[2] 

机构地区：[1]国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津医科大学肿瘤医院疼痛治疗科,天津300060 [2]国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津医科大学肿瘤医院放疗科, 天津300060

出　　处：《中华放射肿瘤学杂志》2015年第5期484-487,共4页Chinese Journal of Radiation Oncology

基　　金：天津市抗癌重大专项攻关计划项目（12ZCDZSY15900）;天津医科大学肿瘤医院“肿瘤转化医学种子基金”

摘　　要：目的：探讨术后放疗对早期SCLC预后影响。方法回顾分析我院1997—2010年临床分期为T1-2 N0 M0期且行根治性切除术的71例SCLC患者临床资料，31例术后放疗，55例术前或术后化疗。 Kaplan-Meier法计算LR率、远处转移率及生存率并Logrank法检验及单因素预后分析，Cox模型多因素预后分析。结果5年样本数32例，5年OS率及LR率分别为52％和22％，术后是否放疗对生存无影响（ P＝0.524）。对于术后N （-）患者行放疗与未行放疗者中位OS分别为47.3个月与96.8个月（ P＝0.561），5年LR率分别为39％与23％（ P＝0.934）。对于术后N （＋）患者行放疗者中位生存明显高于未行放疗者（66.7、34？6个月，P＝0.016），行放疗者5年LR率亦明显低于未行放疗者（5％、75％，P＝0？004）。全组患者远处转移率为30％，术后放疗与否对患者远处转移率无影响（ P＝0.576）。结论术后放疗明显降低了术后N （＋） SCLC患者LR率并提高了生存，而对N （-）患者反而有降低生存趋势，建议术后N （＋）的SCLC患者行术后放疗。Objective To investigate the impact of postoperative radiotherapy （ PORT） on the prognosis of early-stage small cell lung cancer （ SCLC） . Methods The clinical data of 71 patients who were clinically diagnosed with stage T1-2 N0 M0 SCLC and underwent radical resection surgery in our hospital from 1997 to 2010 were retrospectively analyzed. Thirty one patients received PORT, and fifty？five patients received preoperative or postoperative chemotherapy. The locoregional recurrence （ LRR ） , distant metastasis, and overall survival （ OS） rates were calculated using the Kaplan-Meier method. The log-rank test was used for survival difference analysis and univariate prognostic analysis. The multivariate prognostic analysis was made by the Cox regression model. Results The 5 year sample size was 32. The 5 year OS and LRR rates were 52% and 22%, respectively. PORT had no significant impact on OS rate （ P=0.524）. There were no significant differences in median OS and 5？year LRR rates between node-negative patients treated with and without PORT （47.3 vs. 96.8 months, P=0.561;39% vs. 23%, P=0？934）. In the node-positive patients, patients treated with PORT had a significantly higher median OS rate and a significantly lower 5？year LRR rate than those treated without PORT （ 66.7 vs. 34.6 months, P=0？016;5% vs. 75%, P=0.004） . The distant metastasis rate was 30% in all patients, and PORT had no significant impact on the distant metastasis rate （ P=0.576） . Conclusions PORT significantly reduces LRR rate and improves OS rate in node-positive patients with SCLC. However, it slightly reduces OS rate in node-negative patients. Therefore, PORT is recommended for node-positive patients with SCLC.

关 键 词：肺肿瘤/放射疗法 肺肿瘤/外科学 预后 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]