诱导性同步放化疗治疗侵袭性肺上沟瘤(英文)

Induction concurrent chemoradiation therapy for invading apical lung cancer

目的 :分析同步放化疗(CRT)在NSCLC外科治疗的地位。方法 :回顾性总结 1987～1996年外科手术的 3 0例累及胸顶部的NSCLC ,单纯手术组 10例 ,手术 +放疗组 (RT) 9例 ,含铂方案化疗 +放疗组 (CRT) 11例。结果 :单纯手术组 2、4年生存率分别为 3 0 %和 2 0 % ,RT组为 2 2 %和 11% ,CRT组为 73 %和 5 3 %。单因素分析根治性 (是与否比较 ,P =0 0 2 7)和诱导性治疗 (单纯手术和RT与CRT比较 ,P =0 0 173 )是有意义的预后因素。多因素分析仅诱导性治疗 ,P =0 0 2 3 8,是有意义的预后因素。结论 :与诱导性放疗和单纯手术相比 ,CRT可提高累及胸顶部的NSCLC患者的生存率。

OBJECTIVE:Although non-small cell lung cancer (NSCLC) involving the superior sulcus has been generally treated with radiation therapy (RT) followed by surgery, local recurrence is still a big problem to be solved.We investigated a role of induction therapy, especially induction concurrent chemoradiation therapy (CRT), on the surgical results of this type of NSCLC.METHODS:We retrospectively reviewed 30 patients with NSCLC invading the apex of the chest wall who underwent surgery from 1987 to 1996. Ten patients (57±8 years) received surgery alone, 9 (55±13 years) received RT (42±7 Gy) followed by surgery and 11 (51±9 years) received cisplatin based chemotherapy and RT (47±5 Gy) as an induction therapy.RESULTS:Two and 4-year survival rates were 30% and 20% in patients with surgery alone, 22% and 11% in patients with induction RT, and 73% and 53% in patients with induction CRT, respectively. The survival was significantly better in patients with induction CRT than those with induction RT or surgery alone. Univariate analysis demonstrated that curability (yes versus no: P=0.027) and induction therapy (surgery alone and RT versus CRT: P=0.017 3) were significant prognostic factors. Multivariate analysis revealed that only induction therapy,P=0.023 8 was a significant prognostic factor.CONCLUSIONS:Induction CRT seems to improve the survival in patients with NSCLC invading the apex of the chest wall compared with induction RT or surgery alone. [