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收集了1983年至1990年期间,我院确诊并行手术切除的肺腺癌患者69例,男性47例,女性22人,中位年龄52岁。分期:Ⅰ期33例,Ⅱ期16例,Ⅲa期20例。并分成淋巴结阴性与淋巴结阳性两组,进行术后各种辅助治疗逐年生存率的比较,分析了各种辅助治疗与转移部位的关系。发现淋巴结阴性者,术后放疗,其1、3、5年生存率未见明显提高,但术后化疗,可提高3年远期生存率87.5％(P<0.05)。淋巴结阳性者,术后单放或化疗不能明显延长生存期,而辅以放疗加化疗,可以明显延长远期生存率,3年58.3％,5年33.3％,本组随访率为95.6％。术后单纯放疗的患者脏器转移率(78％)比放疗加化疗或化疗脏器转移率(42％～45％)高,前者术后无瘤生存期(1～37个月)比后者(8～50个月)短,作者认为腺癌根治术后淋巴结阴性者应及时补充化疗;淋巴结阳性者术后一定要行化疗,放疗等综合治疗,提高远期生存率。
During the period from 1983 to 1990, 69 patients with lung adenocarcinoma diagnosed concurrently in our hospital were diagnosed, including 47 males and 22 females, with a median age of 52 years. Stages: 33 cases of stage I, 16 cases of stage II, and 20 cases of stage IIIa. The patients were divided into two groups, lymph node negative and lymph node positive, and the survival rates of various adjuvant treatments after surgery were compared. The relationship between various adjuvant treatments and metastatic sites was analyzed. The lymph node-negative patients were found to have no significant increase in 1-, 3-, and 5-year survival rates after radiotherapy, but post-operative chemotherapy could increase the 3-year long-term survival rate by 87.5% (P<0.05). In patients with positive lymph nodes, postoperative radiotherapy or chemotherapy alone did not significantly prolong survival. Supplemented with radiotherapy plus chemotherapy, the long-term survival rate was significantly prolonged, 58.3% in 3 years and 33.3% in 5 years. The follow-up rate in this group was 95.6%. The rate of visceral metastasis (78%) was higher in patients who received radiotherapy after surgery than in those who received chemotherapy or chemotherapy (42% to 45%). The former had a tumor-free survival (1 to 37 months) after the latter. (8 ~ 50 months) short, the author believes that after adenocarcinoma radical surgery, lymph node negative should be promptly added chemotherapy; lymph node positive patients must undergo chemotherapy, radiotherapy and other comprehensive treatment to improve long-term survival.