临床分期为ⅢA(N2)期非小细胞肺癌放射治疗的预后分析  

Prognosis of Clinical Stage ⅢA(N2) Non-small Cell Lung Cancer Patients Received Radiotherapy

作　　者：张瑞[1] 李静[1] 宋玉芝[1] 景仲昊 甄婵军[1] 王硕烁 刘明[1] 乔学英[1] 

机构地区：[1]河北医科大学第四医院放疗科,石家庄050011

出　　处：《肿瘤防治研究》2016年第6期526-530,共5页Cancer Research on Prevention and Treatment

基　　金：河北省科技厅支撑计划项目(12276104D-17)

摘　　要：目的探讨临床分期为ⅢA(N2)期非小细胞肺癌放射治疗的预后及其影响因素。方法收集2010年1月—2011年12月于河北医科大学第四医院接受放射治疗的临床分期为ⅢA(N2)期非小细胞肺癌患者共113例,观察临床疗效,并分析预后影响因素。结果全组1、2、3年生存率分别为70.5%、39.3%、23.8%;1、2、3年局部控制率分别为76.6%、54.5%、47.9%;1、2、3年无病生存率分别为50.6%、25.3%、18.7%。单因素分析显示,性别、ECOG评分、是否化疗和近期疗效与总生存率有关;T分期、GTV大小、是否化疗和近期疗效与局部控制率有关。多因素分析显示,性别、ECOG评分、是否化疗和近期疗效是影响总生存率的独立预后因素,GTV大小、是否化疗和近期疗效是影响局部控制率的独立预后因素。全组≥2级放射性肺炎15例,占13.3%;≥2级放射性食管炎6例,占5.3%;≥2级血液学不良反应20例,占17.7%。结论放射治疗在临床分期为ⅢA(N2)期非小细胞肺癌中疗效确切,不良反应可耐受。性别、ECOG评分、GTV大小、是否化疗和近期疗效为ⅢA(N2)期NSCLC患者预后的主要影响因素。Objective To investigate the efficacy and prognostic factors of clinical stage ⅢA（N2） non-small cell lung cancer（NSCLC） patients treated with 3-dimensional conformal or intensity-modulated radiotherapy. Methods From January 2010 to December 2011, the data of 113 patients with clinical stage ⅢA（N2） NSCLC at the Fourth Hospital of Hebei Medical University were analyzed. The efficacy and prognostic factors were observed. Results The overall 1-, 2- and 3-year overall survival（OS） of entire cohort were 70.5%, 39.3% and 23.8%, respectively. The overall 1-, 2- and 3-year local control rates（LCR） of entire cohort were 76.6%, 54.5% and 47.9%, respectively. The overall 1-, 2- and 3-year disease-free survival（DFS） of entire cohort were 50.6%, 25.3% and 18.7%, respectively. The univariate analysis showed that gender, ECOG performance status, chemotherapy and tumor response were associated with OS; T stage, GTV size, chemotherapy and tumor response were associated with LCR. Multivariate analysis revealed that gender, ECOG performance status, chemotherapy and tumor response were the independent factors for predicting the OS; GTV size, chemotherapy and tumor response were the independent factors for predicting the LCR. There were 13.3%（15/113） patients with grade≥2 acute radiation-related pneumonitis after radiotherapy; there were 5.3%（6/113） patients with grade≥2 acute radiation esophagitis; there were 17.7%（20/113） patients with grade≥2 hematologic toxicity. Conclusion Radiotherapy may be effective in the treatment of clinical stage ⅢA（N2） NSCLC and side-effect can be tolerated. Gender, ECOG performance status, GTV size, chemotherapy and tumor response may be the independent risk factors for predicting the prognosis.

关 键 词：非小细胞肺癌 放射治疗 生存 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]