电视辅助胸腔镜手术和体部立体定向放疗治疗早期非小细胞肺癌的临床疗效比较  

A comparative study on efficacy of TV auxiliary thoracoscopic surgery and stereotactic radiotherapy in treatment of early stage non-small cell lung cancer

作　　者：李放 葛宏雷 金昊 

机构地区：[1]辽河油田总医院心胸外科,辽宁盘锦124010

出　　处：《临床和实验医学杂志》2017年第10期1008-1010,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的对比电视辅助胸腔镜手术(VATS)和体部立体定向放疗(SBRT)治疗早期非小细胞肺癌(NSCLC)的临床疗效。方法选择2010年5月至2012年5月收治的早期NSCLC患者174例,根据治疗方案不同分为SBRT组和VATS组各87例,分别于术后随访5年,观察对比两组总生存率和无病生存率,并于治疗后6个月对比两组生存质量。结果术后分别随访1、3、5年,SBRT组总生存率分别为92.0%、81.6%、71.3%,VATS组总生存率分别为94.3%、86.2%、78.2%,两组各随访时期总生存率比较差异无统计学意义(P>0.05);SBRT组无病生存率分别为88.5%、77.0%、66.7%,VATS组无病生存率分别为92.0%、80.5%、70.1%,两组各随访时期无病生存率比较差异无统计学意义(P>0.05)。于治疗后6个月或末次随访时,SBRT组FACT-L总分为(120.7±8.1)分,高于VATS组的(94.3±9.8)分,差异有显著性(P<0.05)。结论 VATS和SBRT治疗早期NSCLC的远期疗效相当,但SBRT更适用于不能耐受或拒绝接受手术治疗者,且术后远期生存质量高于手术治疗者,可获得更好的临床应用前景。Objective To explore the clinical effect of TV auxiliary thoracoscopic surgery（ VATS） and early stereotactic radiotherapy（ SBRT） in treatment of patients with non-small cell lung cancer（ NSCLC）. Methods A total of 174 patients with early NSCLC in this hospital during May 2010 to May 2012 were divided into SBRT treatment group and VATS group according to different therapeutic regimen,87 cases in each group,they were followed-up for 5 years after the operation. The overall survival rate and disease-free survival rate were compared between these 2 groups after follow-up for 5 years after operation and the living quality of pateitns in 6 months after treatment. Results Postoperative distribution were followed up for 1,3 and 5 years,the overall survival rates of patients in SBRT group were 92. 0%,81. 6% and 71. 3%,and the VATS group overall survival rates in patients of VATS group were 94. 3%,86. 2% and 78. 2% respectively,and the difference in survival rate between these two groups in the follow-up period was not statistically significant（ P〉0. 05）. The disease-free survival rates in patients of SBRT group were 88. 5%,77. 0% and 66. 7% respectively,and in patients of VATS group were 92. 0%,80. 5% and 70. 1% respectively,and the difference between these two groups in the follow-up period was not statistically significant（ P〉0. 05）. In 6 months after treatment or at the time of the last follow-up FACT-L scores（ 120. 7 ± 8. 1） in patients of SBRT group were higher than those of patients in VATS group（ 94. 3-9. 8）（ P〈0. 05）. Conclusion VATS and SBRT in long term curative effect in treatment of early NSCLC are equavalent,but SBRT is more suitable for patients with intolerance or refused to accept the surgical treatment and their postoperative long term survival quality is higher than those with surgery,hence it can obtain better prospect of clinical application.

关 键 词：早期非小细胞肺癌 电视辅助胸腔镜手术 体部立体定向放疗 

分 类 号：R734.2[医药卫生—肿瘤]