调强放疗联合TP方案化疗治疗局部晚期非小细胞肺癌的疗效及预后影响因素分析

Efficacy and related influencing factors of retrograde intensity-modulated radiotherapy combined with TP for local advanced non-small cell lung cancer

目的:探析调强放疗联合TP方案治疗局部晚期非小细胞肺癌的疗效及相关影响因素。方法:回顾性分析124例接受放疗及TP化疗的局部晚期非小细胞肺癌患者的临床数据,根据化疗时机分为同步放化疗组(85例)及序贯放化疗组(39例)。比较两组的远期疗效,采用多因素COX回归分析预后的影响因素。结果:同步放化疗组在治疗后的治疗应答率高于序贯组(70.59%vs 51.28%,P=0.037)。生存随访显示,同步放化疗组的中位生存时间18.2个月高于序贯放化疗组的12.1个月,Log-rank检验P=0.026。对预后进行单因素分析后,年龄、肿瘤直径、CA125、CA199、治疗方案显示有统计学差异。COX多因素分析结果显示,患者年龄>60岁(HR=3.075,95%CI 2.025~4.126)、肿瘤直径>5 cm(HR=5.071,95%CI 2.626~7.118)以及序贯放化疗(HR=1.709,95%CI 1.205~2.113)影响远期疗效。结论:TP方案治疗局部晚期非小细胞肺癌中,同步放化疗方案优于序贯放化疗,其中患者年龄>60岁、肿瘤直径>5 cm、序贯放化疗是预后的危险因素。

Objective:To investigate the efficacy and related influencing factors of intensity-modulated radiotherapy combined with TP in the treatment of locally advanced non-small cell lung cancer.Methods:The clinical data of 124 patients with locally advanced non-small cell lung cancer who underwent radiotherapy and TP chemotherapy were retrospectively analyzed.According to the timing of chemotherapy,they were divided into synchronous group(85 cases)and sequential group(39 cases).Long-term efficacy was compared between the two groups,and multivariate COX regression was used to analyze the prognostic factors.Results:The response rate of the synchronous group was higher than that of the sequential group(70.59%vs 51.28%,P=0.037).Survival follow-up showed that the median survival time of the synchronous group was 18.2 months,higher than that of the sequential group 12.1 months,Log-rank test P=0.026.After univariate analysis of prognosis,age,tumor diameter,CA125,CA199 and treatment regimen showed statistical differences.COX multivariate analysis showed that patients age>60 years old(HR=3.075,95%CI 2.025~4.126),tumor diameter>5 cm(HR=5.071,95%CI 2.626~7.118)and sequentialchemoradiotherapy(HR=1.709,95%CI 1.205~2.113)affect long-term efficacy.Conclusion:Synchronous che-moradiotherapy is superior to sequential chemoradiotherapy in the TP regimen treatment of locally advanced non-small cell lung cancer.The patient age>60 years old,the tumor diameter>5 cm,sequential chemotherapy are prog-nostic risk factor.