NSCLC根治术后pN2期患者不同放化疗模式的疗效分析

Effect of Different Radiotherapy and Chemotherapy Modes on Patients with pN2 Stage NSCLC after Radical Operation

目的:比较序贯放化疗(sequential radiochemotherapy,SCRT)与同步放化疗(concurrent chemoradiotherapy,CCRT)在非小细胞肺癌(nonsmallcelllungcancer,NSCLC)根治术后pN2期患者辅助治疗中的价值。方法:选取2012年1月~2017年12月期间,在四川省肿瘤医院行肺癌根治术后pN2期NSCLC患者92例,据放化疗方式不同分为SCRT组(n=54)和CCRT组(n=38),比较两组副反应,无局部复发生存期(local recurrence free survival,LRFS)、无远处转移生存期(distant metastasis freesurvival,DMFS)、无病生存期(disease free survival,DFS)、总生存(0-verallsurvival,OS)及1年、2年、3年生存率。结果:两组患者在一般资料、病理类型、病理T分期、淋巴结状态等方面差异无统计学意义。CCRT组白细胞减少发生率较SCRT组高,差异有统计学意义(P<0.05),放射性食管炎、放射性肺炎等副反应发生率在两组间差异无统计学意义(P>0.05)。SCRT组的中位DMFS.DFS优于CCRT组,两组的中位LRFS及CCRT组的中位OS暂未达到,但差异均未达到统计学意义(P>0.05),结论:对于根治术后pN2期NSCLC,SCRT与CCRT均是有效的治疗方式,但SCRT的安全性更佳,且SCRT的DMFS、DFS有优于CCRT的趋势,SCRT及CCRT在NSCLC根治术后PN2期患者治疗中的价值有待于进一步探索。

Objective: To compare the value of sequential radiochemotherapy ( SCRT) and concurrent chemoradiotherapy (CCRT) in adjuvant treatment of pN2 patients with non-small cell lung cancer ( NSCLC) after radical resection. Methods: Ninety-two pN2 NSCLC patients after surgery in Sichuan cancer hospital from January 2012 to December 2017 were selected and divided into two groups, SCRT group (n =54) and CCRT group ( n = 38), according to different chemoradiotherapies. Side effects, local recurrence free survival ( LRFS), distant metastasis free survival ( DMFS), disease-free survival ( DFS),overall survival ( OS) and 1 -, 2-and 3-year survival rates were compared between the two groups. Results: There was no significant difference in general information, pathological type, pathological T stage and lymph node status between the two groups. The incidence of leukopenia in CCRT group was higher than that in SCRT group (P<O. 05). There was no significant difference between the two groups in the incidence of side effects such as radiation esophagitis and radiation pneumonia (P >0. 05). Median DMFS and DFS in SCRT group were better than those in CCRT group. Median LRFS in both groups and median OS in the CCRT group were not retrieved. But the differences were not significantly different between the two groups in median DMFS, DFS, LRFS and OS ( P > 0.05 ). Conclusion: For pN2 stage NSCLC patients underwent radical resection, SCRT and CCRT are effective treatment methods, and the safety of SCRT is better. DMFS and DFS from SCRT are better than those from CCRT. The value of SCRT and CCRT needs to be further explored.