Ⅲ期肺癌不同治疗模式的探讨

Different Treatment Modalities of Patients with Stage Ⅲ Lung Cancer

目的探讨Ⅲ期肺癌在不同治疗模式下的远期疗效，以提高患者生存率，改善预后。方法回顾性分析北京市结核病胸部肿瘤研究所自1995-2004年10年间1921例不同病理类型的Ⅲ期肺癌患者在不同治疗模式下的远期疗效并进行比较分析。结果在不同治疗模式下，以手术为主（辅以化、放疗）的综合治疗组606例、单纯手术组317例和非手术组998例，其1、3、5年生存率比较分别为66．0％、62．7％、51．2％;32．3％、21．4％、8-2％和19．3％、13．2％、4．2％。以手术为主的综合治疗组1、3、5年生存率高于单纯手术组和非手术组，其中综合治疗组和单纯手术组与非手术组比较1、3、5年生存率差异均有统计学意义（均P〈0．01）。结论根治性肿瘤切除，同时辅以化、放疗的综合治疗是Ⅲ期肺癌有效的冶疗模式。

Objective In order to improve the survival-rates and study the long-term therapeutic effect of stage Ⅲlung cancer patients with different treatment me4alities. Methods From 1995 to 2004, 1921 patients of stage Ⅲlung cancer treated at our hospital were retrospectively analyzed to compare the long-term therapeutic effect of different treatment modalities. Result There were 606 cases in the combined therapy group （mainly surgical with combined treatment of chemotherapy ＆ radiotherapy） , 317 cases in the surgery alone group and 998 cases in the non-surgicai group. The 1, 3, 5-year survival rates of these three groups were 66.0% （400/606） vs 62.7% （199/317） vs 51.2% （511/998） , 32.34% （196/606） vs 21.45% （68/317） vs8.15% （81/998） , 19.31% （117/606） vs 13.2% （42/317） vs4.2% （42/998） respectively. In comparison, 1, 3, 5-year survival rates of the combined therapy group was higher than the surgery alone and non-surgical groups; Significant differences in 1-year survival rates were found between the combined therapy group and the surgery alone group or the non-surgical group （P 〈 0.01 ） and significant differences in 3, 5-year survival rates among these three groups. Conclusion The combined therapy of radical resection with chemotherapy and radiotherapy is the best treatment modality for stage Ⅲ lung cancer.