Ⅲ_a期非小细胞肺癌术后辅助放疗开始时间对远期生存的影响  

Influence of the interval between postoperative radiotherapy and operation on survival for patients with stage Ⅲ_a non-small cell lung cancer

作　　者：李能平[1] 杨志雄 Li Nengping;Yang Zhixiong(Central Hospital of Guangdong Nongken,Guangdong Zhanjiang 524000,China;Affiliated Hospital of Guangdong Medical University,Guangdong Zhanjiang 524000,China.)

机构地区：[1]广东省农垦中心医院,广东湛江524000 [2]广东医科大学附属医院,广东湛江524000

出　　处：《现代肿瘤医学》2018年第21期3407-3410,共4页Journal of Modern Oncology

摘　　要：目的:分析Ⅲ_a期非小细胞肺癌术后辅助放疗开始时间与手术间隔的时间对患者远期生存的影响。方法:回顾性分析我院收治的42例Ⅲ_a期非小细胞肺癌术后放疗患者的临床资料,其中卡氏评分60～90分;男性22例,女性20例;年龄30～74岁,中位年龄55岁;鳞癌13例,腺癌23例,其它6例;切缘阳性17例,阴性25例;术后放疗开始时间与手术间隔的时间13～120天,放射治疗采用常规放疗或三维适形放疗,放疗剂量40～66 Gy,所有患者均行2～6疗程以铂类为主的双药联合化疗。结果:术后放疗开始时间与手术间隔时间长者(43～120天) 5年生存率好于间隔时间短者(13～42天)(P=0. 040),手术与术后放疗开始时间的间隔对手术切缘阳性者的5年生存率影响差异无统计学意义(P=0. 067)。结论:对Ⅲ_a期非小细胞肺癌患者,术后早放疗并不能提高患者的生存,若术后计划行放化疗,放疗在手术后1个半月后开始可能效果更好。Objective To analyze the influence of the interval between postoperative radiotherapy and operation on long-term survival for patients with stage Ⅲ a non-small cell lung cancer. Methods： The clinical data of 42 patients with stage Ⅲ a non-small cell lung cancer treated with postoperation radiotherapy were analyzed retrospectively,the Karnofsky score was 60 points to 90 points.22 cases were male,20 were female,the age ranged from 30 to 74 years old,the median age was 55 years.13 cases of squamous cell carcinoma,23 cases of adenocarcinoma,6 cases of other pathological types（including 1 case of papillary epithelioma,1 case of papillary carcinoma,and 4 cases of alveolar carcinoma）.17 cases with positive margins and 25 cases with negative results.The time interval berween surgery and radiotherapy ranged 13 to 120 days.Conventional radiotherapy or three-dimensional conformal radiotherapy was used in radiotherapy,and the dose of radiation was 40～66 Gy.All patients received 2 to 6 courses of platinum based double drug combination chemotherapy. Results： The 5 years survival rate of patients with long intervals between postoperative radiotherapy and operation was better than those with short intervals（ P =0.040）.The effect of interval time between postoperative radiotherapy and operation on the 5 years survival rate of the patients with positive margins was not statistically different（ P =0.067）. Conclusion： For patients with stage Ⅲ a non-small cell lung cancer,early postoperative radiotherapy does not improve the patient＇s survival.If postoperative chemotherapy and radiotherapy are performed,radiotherapy may start at 1 and a half months after surgery.

关 键 词：Ⅲa期 非小细胞肺癌 术后放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]