摘要
目的 探讨化疗 +放射治疗 (化放疗 ) <4 0岁青年人肺癌的临床病理及预后。方法 对化放疗的 70例肺癌患者 (<4 0岁 ,研究组 )进行回顾性研究 ,对照组是 82例随机选择同期患者 (≥4 0岁 )。比较两组临床病理特征和生存期。结果 研究组中位年龄 36 .5岁 ,对照组 6 2 .0岁。与对照组相比 ,研究组中女性多 (P =0 .0 39) ,中位症状持续时间长 (4个月 ,P <0 .0 0 1) ,误诊率高 (70 % ,P <0 .0 0 1)及中位误诊时间长 (4个月 ,P <0 .0 0 1) ,腺癌为主要病理类型 (6 4 .3% ,P <0 .0 0 1) ,诊断时晚期多 (90 % ,P <0 .0 0 1) ,放射治疗剂量高 (Ⅰ～Ⅲb期 ,中位剂量 6 2Gy ,P =0 .0 4 8;Ⅳ期 ,中位剂量 5 6Gy,P =0 .0 0 3) ,同期化放疗和早期放射治疗比例高 (77.1% ,P <0 .0 0 1和 5 5 .6 % ,P =0 .0 2 3) ,顺铂剂量高(90mg/m2 ,P <0 .0 0 1)以及化疗周期多 (6个周期 ,P <0 .0 0 1) ;两组在体重减轻、KPS、肿瘤家族史及吸烟史方面无差异。两个组总的中位生存时间及生存率比较差异无显著性意义 (χ2 =2 .88,P =0 .0 90 )。结论 化放疗的青年人肺癌临床病理特征明显不同于≥ 4 0岁人的肺癌 ,但生存情况一致。将青年人肺癌定义为”青年型肺癌”有一定临床实际意义。
Objective To define the clinico-pathologic characteristics and survival of young-robust patients ( <40 years old ) with lung cancer treated by chemoradiation. Methods A retrospective study was carried out on 70 patients with lung cancer in the young, as treated from January 1993 to December 1998. A control group of 82 patients (≥40 years) was randomly selected from the concurrent cases. Comparisons were conducted between the two groups, dealing with clinicopathologic features and survivals. Results Median ages for the study group and control group were 36.5(22-39) and 62(40-89)years, respectively. Compared to the control group, a lower male-female ratio (2∶1 vs 4.5∶1, P=0.039), a longer median duration of symptoms (4 months vs 2 months, P<0.001), a higher mis-diagnosis rate (70.0% vs 25.6%, P<0.001) and longer median duration of mis-diagnosis (4 months vs 2 months, P<0.001), a higher incidence of adenocarcinoma ( 64.3% vs 42.7%, P<0.001) and more advanced disease on diagnosis (90% vs 61%, P<0.001)were defined in the study group. On the other hand, the higher radiation dose (for stage Ⅰ-Ⅲb, 62?Gy vs 60?Gy, P=0.048; for stage Ⅳ, 56?Gy vs 36?Gy, P=0.003 ), higher proportion of concurrent chemoradiation (77.1% vs 48.6%, P<0.001)and earlier radiation intervention (55.6% vs 33.3%, P=0.023 ), higher median dose of DDP (90?mg/m 2 vs 70?mg/m 2, P<0.001), and more cycles of chemotherapy(6 vs 4, P<0.001) were observed in the youngster group. There was no difference between the two groups in family history of cancer, cigarette smoking, weight loss, and KPS. The median survival intervals of all stages (10 months vs 12 months), and the 2- and 5-year survival rates (11.1% vs 23.1% and 3.1% vs 5.4%) were comparable (P=0.090) between them. For stage Ⅲb, there was a trend that young patients would give better outcome than the older ones with median survivals of 11 months to 9 months and the 2-year survivals of 3.8% to 0% (P=0.071). Conclusions The different clinico-pathologic features of the young lung cancer patients are confirmed from that of old patients, but without any survival disparity. In order to enhance our understanding and reduce the mis-diagnosis rate, it is rational to define the lung cancer in relative young people as the youngster lung cancer, which may be beneficial to the clinical practice.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2004年第2期85-88,共4页
Chinese Journal of Radiation Oncology
关键词
青年人
肺癌
化疗
放射治疗
病理学
预后
Lung neoplasms/chemotherapy
Lung neoplasms/radiotherapy
Pathology
Prognosis
