全身化疗联合胸部三维放疗治疗Ⅳ期非小细胞肺癌单器官转移的效果及预后  

Influences factors analysis of prognosis of systemic chemotherapy combined with chest three-dimensional radiotherapy for stage Ⅳ non-small cell lung cancer patients with single organ metastasis

作　　者：王玉梅[1] 马跃民[1] 王建云[2] 曹大平[1] 

机构地区：[1]河北省秦皇岛市第二医院肿瘤综合二科,秦皇岛066600 [2]河北省秦皇岛市第二医院呼吸科,秦皇岛066600

出　　处：《中国肿瘤临床与康复》2016年第6期682-685,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：秦皇岛市科学技术研究与发展计划(201401A092)

摘　　要：目的探讨全身化疗联合胸部三维放疗对Ⅳ期非小细胞肺癌单器官转移患者的预后影响。方法选取2010年1月至2014年9月间收治的118例Ⅳ期非小细胞肺癌单器官转移患者,按照随机数字表法分为观察组和对照组,每组59例。观察组患者采用紫杉醇+顺铂的全身化疗联合胸部三维放疗,对照组患者采用单纯化疗。治疗结束后,观察两组患者的疗效、不良反应和生存情况,采用Lox回归分析研究观察组患者的预后因素。结果所有患者均完成化疗计划,与对照组比较,观察组患者有效率、1年、2年生存率、中位无进展生存期(PFS)和中位生存时间均明显增加,差异均有统计学意义(均P<0.05)。观察组患者的不良反应发生率高于对照组,但差异无统计学意义(P>0.05)。多因素分析结果显示,胸部原发灶计划靶区剂量和转移部位是影响患者生存的独立预后因素。结论对于Ⅳ期非小细胞肺癌单器官转移患者,尤其是骨转移的患者,予以全身化疗联合胸部三维放疗,可提高疗效及生存时间。Objective To explore the influences factors of prognosis of systemic chemotherapy combined with chest three-dimensional radiotherapy to stage Ⅳ non-small cell lung cancer（ NSCLC） patients with single organ metastasis. Methods From January 2010 to September 2014 in The Second Hospital of Qinhuangdao,118 stage Ⅳ NSCLC patients with single organ metastasis were selected as research objects and randomly divided them into the observation group and the contro group,59 cases in each group.The patients in the observation group accepted taxinol plus cisplatin systemic chemotherapy combined with chest three-dimensional radiotherapy,and those in the control group only accepted radiotherapy. After the treatment,the curative effect,toxic reaction and survival rate were evaluated. Regression analysis was used to evaluate the prognosis factors. Results All patients completed radiotherapy plan. Compared with the control group,the effective rate,1-yr,2-yr survival rate,median progression free survival（ PFS） and median survival time of the observation group were all obviously increased,with significant differences（ P〈 0. 05）. The toxic reaction of the observation group was relatively heavier,but with no significant difference（ P〉 0. 05）. Regression analysis showed that chest primary foci planned targeted volume（ PTV） dose and metastatic sites were independent prognosis factors which influenced patients＇ survival. Conclusion For stage Ⅳ NSCLC patients with single organ metastasis,especially osseous metastasis patients adopted systemic chemotherapy combined with chest three-dimensional radiotherapy can relatively improve curative effcacy and survival time.

关 键 词：肺肿瘤 单器官转移 全身化疗 胸部三维放疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]