http://www.100md.com
中国医学科学院肿瘤医院，中国协和医科大学附属肿瘤医院放疗科
朱向帜，王绿化 * ，欧广飞，周宗枚，陈东福，肖泽芬，冯勤付，张红星，汪楣，殷蔚伯
* 通讯作者
【摘要】 目的 评估三维适形放疗治疗局部晚期非小细胞肺癌的疗效、毒性及预后因素。 材料和方法 2001 年 11 月至 2005 年 3 月期间我院采用三维适形放疗治疗组织学证实的局部晚期( ⅢA/B )非小细胞肺癌患者 113 例，分析全组患者的 1,2,3 年生存率和中位生存期及预后因素。 结果 全组 1 、 2 、 3 年生存率分别为 61.4% 、 32.1% 、 22.7% 。中位生存期为 17 月，其中单独放疗组 16 月，序贯放化疗组 18 月，同步放化疗组 16 月。单因素分析显示疗前胸背痛、疗前卡氏评分、血红蛋白、白蛋白水平、大体肿瘤体积( GTV )及近期疗效是影响预后的因素， P 值分别为 0.033 、 0.000 、 0.042 、 0.028 、 0.024 、 0.021 ；多因素分析显示仅疗前卡氏评分是肺癌独立预后因素。 结论 三维适形放疗治疗局部晚期非小细胞肺癌显示了较好的疗效；放疗前卡氏评分是影响局部晚期非小细胞肺癌预后的主要因素。
【关键词】 非小细胞肺癌； 三维适形放疗； 预后因素
【 Abstract 】 Objective To evaluate our institution's experience and identify prognostic factors for LA-NSCLC treated with 3D conformal radiotherapy. Methods One hundred and eighteen patients with stage ⅢA/B non-small-cell lung cancer (LA-NSCLC) were treated with 3D-CRT at CAMS from Nov. 2001 to Mar. 2005. 113 patients were eligible to analyse. 45 cases received radiotherapy alone; 39 cases received concurrent chemoradiation (paclitaxol plus carboplatin in 32 patients, Topotecan in 7 patients); 29 cases received sequential chemoradiation, mostly with platinum-based regiment. Thoracic radiation dose ranged from 26Gy to 75Gy (median 60Gy). GTV and PTV were collected from the 3D treatment plans in 79 and 101 patients, respectively. Overall survival (OS) was calculated using the Kaplan-Meier technique. Comparisons between curves were made using a two-tailed long-rank test. The Cox model was used to perform a multivariate analysis. Results The overall 1 、 2 and 3-year overall survival rate was 61.4%
朱向帜，王绿化 * ，欧广飞，周宗枚，陈东福，肖泽芬，冯勤付，张红星，汪楣，殷蔚伯
* 通讯作者
【摘要】 目的 评估三维适形放疗治疗局部晚期非小细胞肺癌的疗效、毒性及预后因素。 材料和方法 2001 年 11 月至 2005 年 3 月期间我院采用三维适形放疗治疗组织学证实的局部晚期( ⅢA/B )非小细胞肺癌患者 113 例，分析全组患者的 1,2,3 年生存率和中位生存期及预后因素。 结果 全组 1 、 2 、 3 年生存率分别为 61.4% 、 32.1% 、 22.7% 。中位生存期为 17 月，其中单独放疗组 16 月，序贯放化疗组 18 月，同步放化疗组 16 月。单因素分析显示疗前胸背痛、疗前卡氏评分、血红蛋白、白蛋白水平、大体肿瘤体积( GTV )及近期疗效是影响预后的因素， P 值分别为 0.033 、 0.000 、 0.042 、 0.028 、 0.024 、 0.021 ；多因素分析显示仅疗前卡氏评分是肺癌独立预后因素。 结论 三维适形放疗治疗局部晚期非小细胞肺癌显示了较好的疗效；放疗前卡氏评分是影响局部晚期非小细胞肺癌预后的主要因素。
【关键词】 非小细胞肺癌； 三维适形放疗； 预后因素
【 Abstract 】 Objective To evaluate our institution's experience and identify prognostic factors for LA-NSCLC treated with 3D conformal radiotherapy. Methods One hundred and eighteen patients with stage ⅢA/B non-small-cell lung cancer (LA-NSCLC) were treated with 3D-CRT at CAMS from Nov. 2001 to Mar. 2005. 113 patients were eligible to analyse. 45 cases received radiotherapy alone; 39 cases received concurrent chemoradiation (paclitaxol plus carboplatin in 32 patients, Topotecan in 7 patients); 29 cases received sequential chemoradiation, mostly with platinum-based regiment. Thoracic radiation dose ranged from 26Gy to 75Gy (median 60Gy). GTV and PTV were collected from the 3D treatment plans in 79 and 101 patients, respectively. Overall survival (OS) was calculated using the Kaplan-Meier technique. Comparisons between curves were made using a two-tailed long-rank test. The Cox model was used to perform a multivariate analysis. Results The overall 1 、 2 and 3-year overall survival rate was 61.4%