术后辅助放疗对ⅢA-N2期非小细胞肺癌的疗效探讨  

Efficacy of Postoperative Radiotherapy for ⅢA-N2 Non-small Cell Lung Cancer

作　　者：彭苗[1] 苏琼菲[1] 莫凯岚[1] 丁颖[1] 刘晓清[1] 杨帆[1] 王希成[1] 

机构地区：[1]广东药学院附属第一医院,510080

出　　处：《实用癌症杂志》2017年第3期484-488,共5页The Practical Journal of Cancer

摘　　要：目的探讨术后辅助放疗对ⅢA-N2期非小细胞肺癌的疗效。方法 136例经病理学检查确诊为ⅢA-N2期的非小细胞肺癌患者,均行根治性手术及术后辅助化疗,辅助化疗后75例观察(A组),61例行辅助放疗(B组)。结果A组、B组1年总生存率分别为90.7%和98.4%,3年总生存率分别为41.2%和48.7%,5年总生存率分别为30.8%和33.7%(P=0.039)。A组、B组1年无复发生存率分别为87.7%和95.1%,3年无复发生存率分别为59.9%和73.1%,5年无复发生存率分别为47.9%和65.8%(P=0.040)。单因素生存分析提示:吸烟、临床N2期、T分期、阳性淋巴结个数、阳性淋巴结比例、N2淋巴结累及区域、辅助化疗疗程、行术后辅助放疗为预后因素。多因素生存分析提示:临床N2期、T分期、阳性淋巴结个数、行术后辅助放疗为独立预后因素。结论ⅢA-N2期非小细胞肺癌中,术前临床诊断为N2期、T分期越晚、手术切除阳性淋巴结个数越多,预后越差;行术后放疗可提高局控率,延长总生存时间。Objective To study the efficacy of postoperative radiotherapy in ⅢA-N2 non-small cell lung cancer .Meth-ods Clinical data of 136 patients with ⅢA-N2 non-small cell lung cancer were collected .All patients underwent surgery and ad-juvant chemotherapy.After adjuvant chemotherapy 61 patients received adjuvant radiotherapy （group B）,and 75 patients not （A group） .Clinical data were analyzed with univariate and multivariate survival analysis .Results 1-year overall survival rates in group A and group B were 90.7%vs 98.4%,3-year overall survival rates were 41.2% vs 48.7%,5-year overall survival rate were 30.8%vs 33.7%（P=0.039）.1-year recurrence-free survival rates in group A and group B were 87.7%vs 95.1%,3-year recurrence-free survival rates in group A and group B were 59.9%vs 73.1%,5-year recurrence-free survival rates in group A and group B were 47.9%vs 65.8%（P=0.040）.Univariate analysis indicated that smoking ,clinical N2 stage,T stage,num-ber of positive lymph nodes ,the proportion of positive lymph nodes ,N2 lymph node involvement region ,adjuvant chemotherapy , postoperative radiotherapy as prognostic factors .Multivariate analysis showed that clinical N2 stage,T stage,number of positive lymph nodes ,postoperative radiotherapy were independent prognostic factors .Conclusion ⅢA-N2 non-small cell lung cancer , clinical N2 stage has poor prognosis .And the later T stage ,the more the number of positive lymph nodes ,the worse the prognosis . Postoperative radiotherapy can improve the local control rate and prolong overall survival .

关 键 词：非小细胞肺癌 术后放疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]