手术在ⅢB期肺鳞癌综合治疗中的作用  

The role of surgical treatment in the multidisciplinary treatment of stage ⅢB squamous cell lung cancer

作　　者：方启宇[1] 孟淑燕[1] 郁佳[1] 吕梅君[1] FANG Qi-yu;MENG Shu-yan;YU Jia;LV Mei-jun(Department of Medical Oncology,Shanghai Pulmonary Hospital Affiliated to Tongji University School of Medicine,Shanghai　200433,China)

机构地区：[1]同济大学附属上海市肺科医院,上海200433

出　　处：《临床肺科杂志》2018年第5期917-920,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的ⅢB期肺鳞癌放化综合治疗已是共识,手术介入是否致临床获益,报道不一,本研究目的是评价手术治疗在综合治疗中的作用,并验证8版TMN分期对其影响。方法将50例患者按治疗方法分为A组:放疗+化疗组(25例)、B组:手术+放化疗组(25例)。采用Kaplan-Meier方法进行生存分析。结果A组中位无进展生存期(Progression-Free Survival,PFS)为7.0月(95%CI 5.239-8.761),而B组手术组中位PFS为12.0月(95%CI 7.934-16.066)。B组的PFS显著高于A组,差异均有统计学意义,P<0.01。手术对FPS影响有统计学意义(HR=0.468 P<0.01)对于手术组,年龄对PFS有影响因素(HR=2.475,P=0.013)。按照8版新TNM分期,ⅢC期患者中位PFS为9.0月(95%CI 5.893-12.107)低于新分组为ⅢB期的患者中位PFS为10.0月(95%CI 8.490-11.510),但未得出统计学显著性差异。结论ⅢB期鳞癌治疗要以综合治疗为主,手术治疗可使生存受益,并延长无进展生存时间。Objective To evaluate the role of surgical treatment in the multidisciplinary treatment of stageⅢB squamous cell lung,and to verify the effect of TMN 8 on its effect.Methods 50 patients were divided into two groups.The group A was given radiotherapy and chemotherapy(25 cases),and the group B was given operation and chemoradiation(25 cases).Survival analysis was performed using the Kaplan-Meier method.Results The median PFS in the group A was 7 months(95%CI,5.239-8.761),while the median PFS in the group B was 12 months(95%CI,7.934-16.066).The PFS of the group B was significantly higher than that of the group A(P<0.01).The age of the operation group had an influence on PFS(HR=2.475,P=0.013).According to the 8 edition of the new TNM staging,the median PFS for patients with stageⅢC was 9 months(95%CI 5.893-12.107),and the median PFS was 10 months(95%CI,8.490-11.510)for patients who were lower than the new group for stageⅢB,but no statistically significant difference was found.Conclusion The treatment of stageⅢB squamous cell carcinoma should be based on multidisciplinary therapy,where surgical treatment can benefit survival and prolong progression free survival.

关 键 词：鳞状细胞癌 手术 8版TNM 

分 类 号：R734.2[医药卫生—肿瘤]