ⅢA期N_2非小细胞肺癌术后放疗疗效及预后因素分析

Analysis of postoperative radiotherapy effect in the treatment of patients with N_2 non-small cell lung cancer at ⅢA period and its prognostic factors

目的探讨ⅢA期N2非小细胞肺癌术(NSCLC)术后放疗疗效及其预后影响因素。方法收集确诊的195例ⅢA期N2NSCLC术后放疗患者资料,以5年生存情况作为预后指标。结果ⅢA期N2NSCLC1年、3年、5年生存率分别为58.5%、29.7%、19.0%;多因素COX回归结果显示,影响N2期预后的独立因素包括肿瘤体积(OR=2.840)、T分级(OR=1.923)、N2转移组数(OR=2.672)为危险因素,而N2包膜完整性(OR=0.316)和放疗剂量(OR=0.270)为保护因素。结论ⅢA期N2NSCLC患者术后5年生存率较低,预后较差;肿瘤体积越大、T分级越高、N2淋巴结转移组数越多、N2包膜不完整、术后放疗剂量越低,是N2NSCLC期术后预后的独立危险因素。

Objective To explore the curative effect and prognostic factors of radiotherapy in the treatment of patients with Nz non-small cell lung cancer （NSCLC） at ⅢA period. Methods The clinical data of 195 patients with N2 NSCLC were retrospectively ana- lyzed, and 5-year survival was considered as the prognostic index. Results The survival rates of I year, 3 years and 5 years survival rates were respectively 58.5%, 29.7% and 19.0%. The results of multiple factors COX regression showed that the independent risk factors in- eluded gross tumor volume （ OR = 2. 840） , T grades （ OR = 1. 923 ） , and N2 metastasis groups （ OR = 2. 672）. Nz amieula integrity （ OR = 0. 316） and radiotherapy dose （ OR = 0. 270） were protective factors. Conclusion The 5-year survival rate is a little lower in patients with Nz NSCLC with poor prognosis. The independent risk factors include gross tumor volume, high T-grade, Nz metastasis groups, N2 amieula imperfect and low radiation dose.