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目的：回顾性分析根治性放疗的非小细胞肺癌（NSCLC）病例，探讨总疗程时间（OTT）对放疗效果的影响。材料与方法：选择1990年1月－1996年12月间根治性放疗的经病理确诊的Ⅰ－Ⅲb期NSCLC患者256例，生存统计采用Kaplan－Miers法及Log－rank检验，OTT与局控率关系采用线性回归分析，多因素分析采用Cox比例风险模型。结果：全组有45％（114／256）的患者发生疗程中断共137次，前两位原因为医源性耽搁和节假日休息，分别占55％和11％。全组1、3、5年局部控制率分别为54％、24％和19％；总疗程≤45天者分别为74％、35％和25％，总疗程＞45天者则分别为49％、17％和15％（P＜0．001）。103例BED＝80－85Gy患者线性回归显示疗程每延长1周，3年局控率下降9％。总疗程≤45天者与总疗程＞45天者相比，生存期延长，远处转移减少。多因素分析表明：总疗程时间对局控和生存均有显著性意义，对远处转移也有较高的危险度。结论：总疗程时间延长将导致NSCLC放疗疗效的降低。短疗程放疗方案应予提倡。应尽可能避免各种原因导致的疗程中断。
OBJECTIVE: To retrospectively analyze non-small cell lung cancer (NSCLC) cases of curative radiotherapy and explore the effect of total course time (OTT) on radiotherapy. Materials and Methods: 256 patients with stage I-IIIb stage NSCLC diagnosed by radical radiotherapy between January 1990 and December 1996 were selected. The Kaplan-Miers method and Log-rank test were used for survival statistics. OTT and local control rate The relationship was linear regression analysis and multivariate analysis was conducted using the Cox proportional hazards model. RESULTS: A total of 137 treatment interruptions occurred in 45% (114/256) of patients in the entire group. The first two reasons were iatrogenic delays and holiday breaks, which accounted for 55% and 11%, respectively. The local control rates were 54%, 24%, and 19% for the whole group 1, 3, and 5 years; 74%, 35%, and 25% for the total duration of ≤45 days, and 49% for the total duration of treatment >45 days. , 17% and 15% (P<0.001). Linear regression analysis of 103 patients with BED=80-85Gy showed that for each week of extension of treatment, the 3-year control rate decreased by 9%. Patients with a total course of ≤45 days had longer survival periods and fewer distant metastases than those who had a total course of treatment >45 days. Multivariate analysis showed that the total duration of treatment had significant significance for local control and survival, and also had a higher risk for distant metastasis. Conclusion: The prolonged total duration of treatment will lead to a decrease in the efficacy of NSCLC radiotherapy. Short-course radiotherapy programmes should be promoted. Should avoid as much as possible causes of treatment interruption.