摘要
目的 前瞻性分析手术＋术后放疗（A组）和手术＋术中放疗＋术后放疗（B组）非小细胞肺癌的远期疗效。方法 154例随机分为两组，每组各77例。其中鳞癌134例，腺癌17例，混合癌3例。临床分期Ⅰ、Ⅱ、Ⅲ期分别为17、76、61例。B组术中照射剂量15～25Gy，电子线能量9～20MeV。术后照射采用X线照射，剂量均为40～60Gv。结果 A和B组肿瘤局部控制率为49％和62％（P〈0．05）；3、5、7年生存率分别为40％和44％、27％和29％、5％和7％（P〉0．05）。16例死于放射并发症，其中A组2例，B组14例。结论 术中放疗＋术后放疗能提高肿瘤局部控制率，降低复发率，但不能提高远期生存率。
Objective To analyse the long-term effect of non-small cell lung cancer treated with either postoperative irradiation（ group A） or intraoperative radiotherapy（IORT） followed by postoperative irradiation（ group B）. Methods 154 patients with non-small cell lung carcinoma were randomized into two groups（groups A and B） with 77 patients in each. There were 134 squamous, 17 adenocarcinoma and 3 adeno-squamous carcinoma. Seventeen patients had stage Ⅰ ,76 stage Ⅱ and 61 stage Ⅲ lesions. The dose of postoperative irradiation in both groups was DT40-60 Gy. In group B, the IORT dose was 15-2.5 Gy, delivered by 9-16 MeV electrons. Results The local control rate was 49% and 62% in groups A and B, respectively（P 〈 0.05）. The 3-, 5-,and 7-year survival rate was 40% ,44% ,27% and 29% ,5%,7% in groups A and B, respectively（P 〉 0.05）. Sixteen patients died of radiotherapy-induced complication： 2 in group A and 14 in group B. Conclusions Intraoperative radiotherapy followed by postoperative irradiation can enhance the local control rate of non-small cell lung cancer but can not improve the long term survival. The high complication mortality rate of IORT （18%） in contrast to that （3%） of postoperative radiotherapy is worth noticing.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第1期15-18,共4页
Chinese Journal of Radiation Oncology
关键词
肺肿瘤/外科学
肺肿瘤/放射疗法
放射疗法
手术中
预后
Lung neoplasms/surgery
Lung neoplasms/radiotherapy
Radiotherapy , intraoperative
Prognosis
