小细胞肺癌预防性脑照射临床探讨

目的 探讨预防性全脑照射对局限期小细胞肺癌脑转移率和生存率的影响。方法 6 4例经化疗加放射治疗后完全缓解的局限期小细胞肺癌病例被随机分为脑照射组和对照组。脑照射组在肿瘤确诊后 5～ 6个月 ,开始常规分割照射 ,采用双侧野照射 ,剂量为 30～ 36GY。结果 脑照射组脑转移率为 6 .2 5 % ,对照组为5 3.13%。 1、3、5年生存率脑照射组、对照组分别为 71.88%、4 0 .6 3%、2 5 % ,5 0 %、2 1.88%、12 .5 % ,两组比较差异有显著性意义。结论 预防性全脑照射能减少局限期小细胞肺癌的脑转移 ,提高生存率。

Perioperative chemotherapy of stage Ⅲ N2 non-small cell lung cancer

Patients with stage Ⅲ N2 non-small cell lung cancer （NSCLC） are more than one third of all NSCLC patients. The 5-year survival rate of them is approximately 15%. From therapeutic views, stage ⅢA N2 of 97 International Lung Cancer Staging System is an obvious hetero-combination, which includes mediastinal lymph node metastasis based on microscope after postoperative examination and N2 of single station or N2 of multiple stations based on computerized tomographic scanning and N2 of mediastinal lymph node mixed together. The different status of stage N2 lead to different prognosis. Andre et al reported the results of continuous surgery in 702 patients with NSCLC, which showed that N2 of single station based on microscope, 5-year survival rate was 34% （244 cases）, N2 of multiple stations based on microscope, 5-year survival rate was 11% （788 cases）, N2 of single station based on radiograph, 5-year survival rate was 8% （118 cases）,