Ⅳ期NSCLC化疗同期3 DRT前瞻性、多中心Ⅱ期临床研究--不同病理类型生存再分析（PPRA-RTOG003）  

A prospective,multicenter,phase Ⅱclinical study of three-dimensionalradiotherapy with concurrent chemotherapy for stage IV non-small-cell lung cancer-The impact of different pathological types on survival （PPRA-RTOG003）

作　　者：邓蓉[1] 李涛[2] 李建成[3] 王小虎[4] 卢铀[5] 陈明[6] 柏玉举[7] 苏胜发[8] 欧阳伟炜[8] 李青松[8] 马筑[8] 胡银祥[8] 粟惠芹[8] 何志旭[9] 卢冰[8] 

机构地区：[1]贵州医科大学肿瘤学教研室,550004 [2]四川省肿瘤医院放疗科 [3]福建省肿瘤医院放疗科 [4]甘肃省肿瘤医院放疗科 [5]四川大学华西医院肿瘤中心胸部肿瘤科 [6]浙江省肿瘤医院放疗科 [7]遵义医学院附属医院附属肿瘤医院胸部肿瘤科 [8]贵州医科大学附属医院,贵州省肿瘤医院肿瘤科,550004 [9]贵州医科大学组织工程与干细胞实验中心

出　　处：《中华放射肿瘤学杂志》2016年第10期1051-1056,共6页Chinese Journal of Radiation Oncology

基　　金：贵州省科技攻关项目[SY[2010]3078,SY2012-3079];贵州省应用基础研究计划重大专项（黔科合J重大字[2015]2003）

摘　　要：目的：研究不同病理类型Ⅳ期NSCLC化疗同期原发肿瘤胸部3 DRT的生存。方法对2008—2012年一项前瞻性临床研究再分析入组203例，可评价病理类型174例。鳞癌51例，非鳞癌123例。化疗以铂类为基础的两药联合方案，中位周期数4周期。原发肿瘤中位剂量63 Gy。Kaplan-Meier法计算OS并Logrank检验和单因素分析，Cox回归模型多因素分析。结果全组1、2、3年OS及中位生存期分别为56％、16％、9％及13个月。单因素分析显示鳞癌和非鳞癌在相同化疗周期、原发肿瘤剂量、器官转移状态、N分期、2周期化疗获益和近期疗效有效时的1、2、3年OS和中位生存期相近（所有P＞0.05）；T1—T2期非鳞癌1、2、3年OS及中位生存期优于鳞癌（ P＝0.000）。多因素分析显示不同病理类型、性别、年龄、化疗周期数对生存均无影响（所有P＞0.05），原发肿瘤剂量对生存有影响（ P＝0.007）。结论Ⅳ期NSCLC化疗同期原发肿瘤3DRT模式下不同病理类型对生存无影响，但 T1—T2非鳞癌患者 OS 可能延长。临床试验注册 ClinicalTrials． gov，注册号：ChiCTRTNC10001026。Objective To evaluate the survival of different pathological types with concurrent chemotherapy and thoracic three-dimensional radiotherapy （ CCTTRT ） for stage Ⅳ non-small-cell lung cancer （ NSCLC） . Methods Two hundred and three patients of stageⅣNSCLC were enrolled from 2008 to 2012. Of the 174 patients eligible for analysis, The patients of squamous carcinoma and non-squamous carcinoma were 51 and 123,respectively. Patients were treated by platinum-based chemotherapy,the median number of cycle was 4. The median dose of primary tumor was 63 Gy. Survival was calculated by Kaplan-Meier method and compared using the Logrank. Cox regression model were used to examine the effect of response on overall survival. Results Of 174 patients,the 1-,2-,and 3-year overall survival （ OS） rates and median survival time （ MST） were 56%,16%,9% and 13 months,respectively. For patients under the same cycles of chemotherapy,the same dose of primary tumor,the same metastasis states,the same N staging,and when two cycles of chemotherapy and the recent curative effect are effective, no matter whether squamous carcinoma or non-squamous carcinoma, the 1-, 2-, and 3-year OS rates and MST were not statistically significant （all P〉0.05）.At the same of T staging （T1-T2）,the 1-,2-,and 3-year OS rates and MST for the patients of non-squamous carcinoma were better than squamous carcinoma （P=0.000）.Multivariate analysis showed that different pathological types, gender, age and the cycles of chemotherapy were not independent factors for survival （ all P〉0.05 ） , but those treated with DTPTV≥63 Gy can prolong survival time. Conclusions CCTTRT had no effect on different pathological types of survival. The survival of non-squamous carcinoma may be extended when the T staging was T1-T2.Clinical Trial Registry ClinicalTrials. gov,registration number：ChiCTRTNC10001026.

关 键 词：癌 非小细胞肺/三维放射疗法 癌 非小细胞肺/同期化放疗法 病理因素 预后 

分 类 号：R734.2[医药卫生—肿瘤]