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目的 评价术后放疗对根治术后N1与N2 非小细胞肺癌的作用。方法 1982年 2月至 1995年12月收治的 36 6例小于 6 5岁的N1与N2 非小细胞肺癌病例 ,随机分为术后放疗组 (n =184)和单纯手术组 (n= 182 )。结果 术后放疗组和单纯手术组 5年生存率分别为 43 .4%± 5 .1%和 40 .5 %± 4.6 % (P =0 .5 6 ) ,5年无瘤生存率分别为 42 .9%± 5 .2 %和 38.3 %± 4.5 % (P =0 .2 8)。T3 4 N1M0 患者在术后放疗组的 5年生存率和5年无瘤生存率分别为 5 8.1%± 15 .5 %和 6 5 %± 12 % ,单纯手术组则分别为 39.9%± 10 .2 % (P =0 .0 92 )和40 %± 10 % (P =0 .0 5 7)。术后放疗可明显减少胸内复发 (P <0 .0 1)。结论 术后放疗可减少局部复发 ,对总的生存改善不明显 ,但对T3 4 或N1患者有望获得治疗益处
Objective To evaluate the effect of postoperative radiotherapy on N1 and N2 non-small cell lung cancer after radical resection. Methods A total of 366 patients with N1 and N2 NSCLC less than 65 years of age admitted from February 1982 to December 1995 were randomly assigned to receive postoperative radiotherapy (n = 184) and surgery alone (n = 182). . Results The 5-year survival rates of postoperative radiotherapy group and surgery alone group were 43.4%±5.1% and 40.5±4.6% (P=0.56), respectively. The 5-year disease-free survival rate was 42. .9%±5.2% and 38.3%±4.5% (P=0.28). The 5-year survival rate and 5-year disease-free survival rate of T3 4 N1M0 patients in the postoperative radiotherapy group were 58.1% ± 15.5% and 65 % ± 12%, respectively, and 39.9% ± 10 in the surgery alone group. 2% (P =0. 0 92) and 40% ± 10% (P =0. 0 5 7). Postoperative radiotherapy significantly reduced intrathoracic recurrence (P < 0.01). Conclusion Postoperative radiotherapy can reduce local recurrence and improve overall survival, but it is expected to have therapeutic benefits for T3 4 or N1 patients.