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目的:对非小细胞肺癌(NSCLC)适形放疗的生存率及其影响因素进行初步探讨。方法:对45例NSCLC进行适形放疗,对其中病理诊断、分期(UICC1997)明确的24例进行了随访、分析:男19例、女5例;年龄49岁-81岁(中位年龄65岁);鳞癌22例、腺癌2例;中心型12例、周围型12例(不详3例);拓能公司适形放疗治疗系统、8Mv-X线体外照射。17例全程适形放疗,每周3次,每次约5Gy-6Gy,5例先常规大野放疗37Gy-48Gy,然后适形放疗补量TDF44-87.5(67.3±17.5)Gy,2例分别为常规放疗15、24月后复发的二程放疗,适形放疗(相当于常规分割)42Gy、68Gy。放疗前行化疗、探查术、根治术者分别为2例、1例、1例。自治疗开始日计,Kaplan-Meier法计算生存率,Cox比例风险模型对性别、年龄、X片分型、T、N(是否小于N2)、M分期六个因素进行多因素分析。结果:全组2年生存率32.78%,Ⅰ、Ⅱ、Ⅲ、Ⅳ期2年生存率分别为62.50%、50.00%、18.18%、0%,N0-N3的2年生存率分别为43.75%、60%、0%、0%,Cox回归6个因素中,性别、淋巴结转移是否小于N2是独立的预后影响因素。结论:适形放疗对NSCLC有较好疗效,男性较女性、N0-1较N2-3分期患者疗效更好,有较大差异。对单纯高T分期仍有可能获得较好疗效。
Objective: To investigate the survival rate of non-small cell lung cancer (NSCLC) conformal radiotherapy and its influencing factors. Methods: Forty-five patients with NSCLC underwent conformal radiotherapy. Twenty-four patients with definite pathological diagnosis and staging (UICC1997) were followed up and analyzed. There were 19 males and 5 females, aged 49-81 years (median age 65 years ); Squamous cell carcinoma in 22 cases, adenocarcinoma in 2 cases; central type in 12 cases, peripheral type in 12 cases (unknown 3 cases); Tuneng company conformal radiotherapy treatment system, 8Mv-X line in vitro irradiation. 17 cases of full conformal radiotherapy, 3 times a week, each about 5Gy-6Gy, 5 cases of conventional large wild-type radiotherapy 37Gy-48Gy, then the amount of conformal radiotherapy TDF44-87.5 (67.3 ± 17.5) Gy, 2 cases were routine Radiotherapy 15,24 months after the recurrence of two-way radiotherapy, conformal radiotherapy (equivalent to conventional segmentation) 42Gy, 68Gy. Radiotherapy before chemotherapy, exploration, radical surgery were 2 cases, 1 case, 1 case. Kaplan-Meier method was used to calculate the survival rate and the Cox proportional hazards model was used to analyze the six factors including gender, age, X-ray classification, T, N (less than N2) and M staging. Results The 2-year overall survival rate was 32.78%. The 2-year survival rates of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 62.50%, 50.00%, 18.18% and 0% respectively. The 2-year survival rates of N0- 60%, 0%, 0%, Cox regression 6 factors, gender, lymph node metastasis is less than N2 is an independent prognostic factor. CONCLUSION: Conformal radiotherapy has a good effect on NSCLC. Compared with women, N0-1 is more effective and has a greater difference in patients with N2-3 staging. For simple high T staging is still possible to obtain a better effect.