129例肺癌重复癌的临床分析  

Combined therapy for 129 patients with second primary lung cancer

作　　者：梁军[1] 冯勤富[1] 王绿化[1] 章耀鸿[1] 赵宏发[1] 翁欣然[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2004年第1期13-15,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　分析肺癌重复癌的临床特点与预后。方法　 12 9例第一原发非肺癌的肺癌重复癌第一原发癌与原发肺癌确诊的间隔时间为 10天至 317个月 (中位时间 4 9个月 ) ,Ⅰ、Ⅱ、Ⅲ和Ⅳ期分别有 11、2 9、75和 14例。原发肺癌单纯手术治疗 30例 ,单纯放射治疗 5 4例 ,单纯化疗 8例 ,手术加放射治疗 12例 ,放射治疗加化疗 2 0例 ,手术加化疗 4例 ,手术加放射治疗加化疗 1例。结果　全组 2、3和 5年生存率分别为 4 0 .2 %、2 7.2 %和 15 .3% ,Ⅰ、Ⅱ、Ⅲ和Ⅳ期的 2年生存率分别为 71.6 %、6 0 .7%、32 .9%和 0 % (χ2 =30 .0 8,P <0 .0 1)。Ⅱ期手术治疗 (2 0例 )和非手术治疗 (9例 )的 2年生存率分别为 73.9%和 33.3% (χ2 =6 .4 5 ,P <0 .0 5 )。两病变间隔 >4 9个月者和≤ 4 9个月者的 2年生存率分别为 4 3.2 %和 37.4 % (χ2 =0 .80 ,P >0 .0 5 )。结论　第一原发非肺癌的肺癌重复癌与原发性肺癌的临床特点与预后相似 ,失败原因主要为肺肿瘤 ,病期与能否手术治疗是影响预后的因素。ObjectiveTo analyze the clinical characteristics and prognosis of the second primary lung cancer. MethodsThe interval between the second primary lung cancer and the previous primary cancer ranged from 10 days to 317 months( median 49 months).Of the 129 patients treated from 1971 to 1997 by surgery only,radiotherapy only and chemotherapy only or combined therapy,11(8.5%) patients had stage Ⅰ,29(22.5%) stage Ⅱ, 75(58.1%) stage Ⅲ and 14(10.9%)stage Ⅳ; 30 patients received surgery alone,54 radiotherapy alone,8 chemotherapy alone, 12 surgery plus radiotherapy,20 radiotherapy plus chemotherapy,4 surgery plus chemotherapy and 1 surgery plus radiotherapy plus chemotherapy. Results The overall 2-,3- and 5-year survival rates were 40.2%,27.2% and 15.3%. The stage Ⅰ,Ⅱ,Ⅲ and Ⅳ 2-year survival rates were 71.6% ,60.7%,32.9% and 0%,respectively(P<0.01). The stage Ⅱ 2-year survival rates were 73.9% and 33.3% in 20 operated and 9 non-operated patients(P<0.05). The 2-year survival rates were 43.2% and 37.4% on >49 and ≤49 months of the interval between the second primary lung cancer and the previous primary cancer(P>0.05)Conclusions Second primary lung cancer are similar to the first primary lung cancer in clinical characteristics and prognosis . The main cause of failure is lung cancer perse. Stage and being able to operation are prognostic factors.

关 键 词：肺癌 重复癌 临床特点 预后 手术治疗 放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]