肺癌术后放疗疗效的影响因素

Affecting factors on the effect of radiotherapy after postoperation of lung cancer

目的 分析肺癌术后放射治疗疗效的影响因素。方法 1994年5月～1997年9月收治的肺癌术后患者128例,采用60Co或X线放疗,肿瘤照射剂量为40～60 Gy。用单因素和Logistic多因素回归分析法分析影响术后放疗疗效的因素。结果 鳞癌生存率高于小细胞癌,小细胞癌高于腺癌;复发率鳞癌生存率低于腺癌,腺癌低于小细胞癌。N0-1比N2-3生存率高。肿瘤有残留者生存率小于切缘阳性者和(或)局部淋巴结阳性者,且复发率高(P<0.01)。照射剂量≥50 Gy者生存率高于<50 Gy者,且复发率低(0.05>P>0.01)。性别、年龄、术后放疗时间不影响预后。结论 肺癌术后放疗影响生存率、复发率的主要因素为病理类型、术后残留情况、淋巴结转移范围和照射剂量。

Objective To analyze the affecting factors of radiotherapy in lung cancer after operation. Methods A total of 128 patients with lung cancer were treated after operation by radiotherapy with 40 ~ 60 Gy 60Co-X-rays to the tumor in our hospital from May, 1994 to September, 1997.Logistic regression model was used to analyze retrospectively the affecting factors.Results Patients with squamous cell cancer had a better survival rate and a less recurrent rate than those with small cell lung cancer or adenocarcinoma. There was a better survival rate in patients with N0-1I than those with N2-3 . Patients with residues of tumor got a better survival rate and a less recurrence rate than patients with tumor stump, residues and/or N1-2 ( P < 0.01) . Patients who received radiotherapy with Dr>50 Gy had a better survival rate and a less recurrent rate than those with DT < 50 Gy(0.05 > P > 0.01). Sex,age and radiotherapy time after operation did not affect the prognosis. Conclusion Pathologic type, range of lymph nodes metastases, the residues of tumor and the irradiation dose can affect the result of radiotherapy to the residues of none-small cell lung cancer after operation.