中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (12): 1124-1128.doi: 10.12007/j.issn.0258-4646.2017.12.014

• 论著 • 上一篇    下一篇

不可手术局部晚期非小细胞肺癌放化疗安全性及疗效分析

袁梦, 韩琤波, 马洁韬, 黄乐天, 张树玲, 孙丽   

  1. 中国医科大学附属盛京医院肿瘤科, 沈阳 110022
  • 收稿日期:2017-03-16 出版日期:2017-12-30 发布日期:2017-12-08
  • 通讯作者: 韩琤波 E-mail:hancb@126.com
  • 作者简介:袁梦(1991-),女,硕士研究生.

Safety and Efficacy of Chemotherapy and Radiotherapy for the Treatment of Unresectable Locally Advanced Non-small Cell Lung Cancer

Yuan Meng, Han Chengbo, Ma Jietao, Huang Letian, Zhang Shuling, Sun Li   

  1. Department of Oncology, Shengjing Hospital, China Medical University, Shenyang 110022, China
  • Received:2017-03-16 Online:2017-12-30 Published:2017-12-08

摘要: 目的 回顾性分析不可手术局部晚期非小细胞肺癌(LA-NSCLC)的放化疗疗效和安全性及影响其预后的因素。方法 收集2010年1月至2015年12月于我科治疗的不可手术LA-NSCLC患者98例。其中单纯放疗组26例、同步放化疗组37例、序贯放化疗组35例,统计其无进展生存期(PFS)及总生存时间(OS)。采用Kaplan-Meier绘制生存曲线,并用log-rank/Breslow检验进行组间比较;单因素和COX多因素回归分析PFS和OS的独立预后因素。结果 序贯放化疗组的中位PFS优于单纯放疗组,同步及序贯放化疗的中位OS均优于单纯放疗组(P < 0.05)。较早的淋巴结分期、双药联合化疗及联合应用放化疗是PFS获益的独立影响因素;较早的淋巴结分期是OS获益的独立影响因素;总体治疗安全性良好,血液学毒性与化疗方案及患者的KPS评分相关(P < 0.05)。结论 对于LA-NSCLC,较早的淋巴结分期、双药联合化疗及联合应用放化疗治疗是PFS获益的独立影响因素;较早的淋巴结分期是OS获益的独立影响因素。总体治疗安全性良好,但联合化疗和较低的KPS评分会增加血液学毒性。

关键词: 局部晚期, 非小细胞肺癌, 生存, 临床疗效, 毒性反应

Abstract: Objective The aim of this study was to retrospectively review the efficacy and safety of treatment for unresectable locally advanced non-small cell lung cancer (LA-NSCLC). Methods A total of 98 patients treated in our hospital between January 2010 and December 2015 were enrolled in this study. Patients were divided into three groups:the thoracic radiotherapy (TRT) alone,concurrent chemoradiotherapy,and sequential chemoradiotherapy groups. The progression-free survival (PFS) and overall survival (OS) were analyzed via the Kaplan-Meier method,and compared with the log-rank/Breslow test. The prognostic factors were analyzed using the Kaplan-Meier and Cox multivariate proportional hazards models. Results The median PFS in the concurrent therapy group was longer than that in the TRT alone group (P < 0.05). The median OS was improved in patients treated with concurrent or sequential therapy than in the TRT alone group (P < 0.05). N stage, chemotherapy regimens,and radiotherapy modalities were independent prognostic factors of PFS in all patients (P < 0.05). Similarly,N stage was an independent prognostic factor of OS in all patients (P < 0.05). Overall,the treatment was deemed safe. The occurrence of hematotoxicity related to Karnofsky performance score (KPS) and chemotherapy regimens (P < 0.05). Conclusion Patients with a lower N stage who received cisplatin-based double chemoradiotherapy demonstrated improved survival rates. Survival was significantly improved in LA-NSCLC patients treated with concurrent or sequential therapies compared with TRT alone. Overall,the treatment is safe. KPS and chemotherapy combination regimens may increase the occurrence of hematotoxicity.

Key words: locally advanced, non-small cell lung cancer, efficacy, survival, toxicity

中图分类号: 

  • R734.2
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