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目的探讨全身化疗联合胸部三维放疗对Ⅳ期非小细胞肺癌单器官转移患者的预后影响。方法选取2010年1月至2014年9月间收治的118例Ⅳ期非小细胞肺癌单器官转移患者,按照随机数字表法分为观察组和对照组,每组59例。观察组患者采用紫杉醇+顺铂的全身化疗联合胸部三维放疗,对照组患者采用单纯化疗。治疗结束后,观察两组患者的疗效、不良反应和生存情况,采用Lox回归分析研究观察组患者的预后因素。结果所有患者均完成化疗计划,与对照组比较,观察组患者有效率、1年、2年生存率、中位无进展生存期(PFS)和中位生存时间均明显增加,差异均有统计学意义(均P<0.05)。观察组患者的不良反应发生率高于对照组,但差异无统计学意义(P>0.05)。多因素分析结果显示,胸部原发灶计划靶区剂量和转移部位是影响患者生存的独立预后因素。结论对于Ⅳ期非小细胞肺癌单器官转移患者,尤其是骨转移的患者,予以全身化疗联合胸部三维放疗,可提高疗效及生存时间。
Objective To investigate the effect of chemotherapy combined with thoracic radiotherapy on the prognosis of patients with stage IV non-small cell lung cancer with single organ metastasis. Methods One hundred and fourty-eight patients with stage IV non-small cell lung cancer who were admitted to our hospital from January 2010 to September 2014 were randomly divided into observation group and control group with 59 cases in each group. Patients in the observation group were treated with paclitaxel + cisplatin combined with three-dimensional radiotherapy of chest and chemotherapy in the control group. After treatment, the efficacy, adverse reactions and survival of the two groups were observed. The prognostic factors of the observation group were studied by Lox regression analysis. Results All patients completed the chemotherapy regimen. Compared with the control group, the effective rate, 1-year and 2-year survival rate, median progression-free survival (PFS) and median survival time of the observation group were significantly increased, with statistical differences Significance (all P <0.05). The incidence of adverse reactions in observation group was higher than that in control group, but the difference was not statistically significant (P> 0.05). The results of multivariate analysis showed that the target dose and metastasis site of the planned primary thoracic cavity were independent prognostic factors affecting the survival of patients. Conclusion For patients with stage IV non-small cell lung cancer with single organ metastasis, especially in patients with bone metastasis, systemic chemotherapy combined with chest three-dimensional radiotherapy can improve the efficacy and survival time.