Ⅲ期非小细胞肺癌合并活动性肺结核放疗时机的探讨  

Timing of radiotherapy for stage Ⅲ non-small cell lung cancer complicated by active pulmonary tuberculosis

作　　者：梁香存[1] 梁凯[2] 王庆[1] 李华[1] 张红斌[1] 赵敏[1] 

机构地区：[1]河北省胸科医院肺肿瘤二科,石家庄市050041 [2]石家庄经济学院职工医院,050031

出　　处：《实用医学杂志》2015年第21期3534-3536,共3页The Journal of Practical Medicine

摘　　要：目的：探讨Ⅲ期非小细胞肺癌合并活动性肺结核的放疗时机。方法：回顾分析2008年1月至2013年12月在我院接受放疗的Ⅲ期非小细胞肺癌合并活动性肺结核95例。早放疗组（抗痨1-2周后开始放疗）50例,晚放疗组（抗痨1-2个月后开始放疗）45例。比较两组患者疗效及毒副反应。结果：早放疗组与晚放疗组的结核吸收率分别为72.0%、82.2%,无变化率分别为28.0%、17.8%,恶化率均为0%,两组相比差异无显著性（P=0.238）;1、2、3年总生存率分别为67.1%、43.3%、18.5%及63.6%、17.2%、2.9%（P=0.046,χ^2=3.635）。结论：Ⅲ期非小细胞肺癌合并活动性肺结核放疗时机选择在抗痨1-2周后开始较合理,没有导致结核播散,延长了患者的总生存。Objective To explore the timing of radiotherapy for stage Ⅲ non-small cell lung cancer （NSCLC） complicated by active puhnonary tuberculosis. Methods The data on 95 patients with stage m NSCLC complicated by active tuberculosis who had received radiotherapy in our hospital from January 2008 to December 2013 were retrospectively analyzed. The early radiotherapy group （50 patients） was irradiated 1 to 2 weeks after anti-tuberculosis treatment. The delayed radiotherapy group （45 patients） received radiation 1 to 2 months after anti-tuberculosis treatment. The efficacy and radiation-related toxic reaction were compared between the two groups. Results The tuberculosis absorption rate was 72.0% in the early radiotherapy group and 82.2% in the delayed radiotherapy group, nonresponserates was 28.0% and 17.8%, and deterioration rate was 0%, re- spectively, with no significant differences between the two groups （P = 0.238）. The 1-, 2-, and 3-year survival rates were 67.1%, 43.3%, and 18.5% and 63.6%, 17.2%, and 2.9%, respectively （P = 0.046, Х^2 = 3.635）. Conclusions It is more reasonable to start radiotherapy for stage lU non-small cell lung cancer complicated by active tuberculosis 1 to 2 weeks after anti-tuberculosis treatment, which improves the overall survival rate and can not lead to deterioration of tuberculosis.

关 键 词：癌 非小细胞肺 活动性肺结核 放疗时机 

分 类 号：R734.2[医药卫生—肿瘤]