摘要
目的:分析发生单器官转移的非小细胞肺癌(NSCLC)患者化疗同期胸部三维放疗联合转移灶放疗的疗效及预后影响因素。方法:我院2003-01-23-2010-07-06收治Ⅳ期NSCLC化疗同期胸部三维放疗的201例患者,选取其中单器官转移且原发灶和转移灶均放疗的75例患者作为研究对象,对疗效及预后因素进行分析,Kaplan-Meier法计算生存率并Log-rank检验,Cox回归模型行多因素预后分析。结果:75例患者中,单纯脑转移20例,骨转移33例,其他转移22例。中位随访时间10个月(3～55个月),中位生存期为11.0个月(95%CI为7.5～14.5),1、2和3年生存率分别为49.6%、20.8%和12.1%。脑转移的中位生存期9.0个月(95%CI为6.5～15.5),骨转移的中位生存期14.0个月(95%CI为9.1～22.5),其他单器官转移的中位生存期11.0个月(95%CI为8.8～13.2)。胸部原发灶放疗处方剂量≥63Gy和<63Gy的中位生存期分别为17.0个月(95%CI为13.0～21.0)和9.0个月(95%CI为7.0～11.0)。多因素分析显示,转移部位和胸部原发灶放疗的剂量是影响总生存的独立预后因素。结论:单器官转移的NSCLC化疗同期胸部三维放疗+转移病灶放疗疗效较好,胸部原发灶较高剂量放疗及骨转移患者生存获益较大。
OBJECTIVE： To evaluate the treatment outcomes and predictive factors of patients with non-small cell lung cancer and single organ metastasis treated with metastatic lesions radiotherapy and concurrent chemoradiotherapy. METHODS： Clinical data of 75 NSCLC patients with single organ metastases were collected,all patients received radiation to primary tumor and metastatic lesions. The Kaplan-Meier method was used to calculate the OS. The Log-rank test was used to compare the survival curves. Multivariate cox regression analyses was used to test independent significant prognos tic factors for OS. RESULTS： For the whole group, 20 patients had brain metastasis, 33 had bone metastasis, and 22 pa- tients with other organ metastasis. The median follow-up period was 10.0 months （range, 3--55）. The median survival time （MST） was 11.0 months （95 % CI：7.5--14.5）, and the 1-, 2- and 3-year overall survival rate was 49.6 %, 20.8 and 12.1%, respectively. The MST was 9.0 months （95 CI：6. 5-15. 5） for patients with brain metastasis, 14.0 months （ 95 M CI： 9.1 -- 22.5） for those with bone metastasis, and 11.0 months （95 % CI： 8.8-- 13.2） for patients with other organ metastasis. The MST was 17. 0 months（95% CI： 13. 0- 21. 0） for patients with thoracic radiation prescribed dose 63 Gy,whereas 9.0 months （95CI：7. 0--11. 0） for those with dose 〈63 Gy. Multivariate analysis showed that the significant prognostic factors included the organ of metastasis and thoracic radiation dose. CONCLUSION： System chemo- therapy with concurrent thoracic three dimensional radiotherapy and metastatic lesions radiotherapy for patients with NSCLC and single organ metastasis yielded satisfactory overall survival; and those with bone metastasis and higher radia- tion dose to primary thoracic tumor had better treatment outcome.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第14期1102-1105,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
贵州省科技公关项目〔SY(2010)3078〕
贵州省科学技术自然基金〔J(2010)2186〕
关键词
癌
非小细胞肺
同期化放疗法
放射疗法
三维
预后
carcinoma, non-small cell lung/concurrent chemoradiotherapy radiotherapy, three-dimensional prognosis
