| 孙晓江,季永领,郑远达.87例非小细胞肺癌根治术后局部复发预后因素分析[J].肿瘤学杂志,2012,18(11):811-814. |
| 87例非小细胞肺癌根治术后局部复发预后因素分析 |
| An Analysis of Prognostic Factors of Local Recurrence Following Radical Surgery in 87 Cases with Non-small Cell Lung Cancer |
| 投稿时间：2012-06-28 |
| DOI： |
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| 中文关键词: 癌，非小细胞肺 复发 预后 外科手术 放射疗法 |
| 英文关键词:carcinoma,non-small cell lung recurrence prognosis surgery radiotherapy |
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| 中文摘要: |
| 摘 要:［目的］ 探讨非小细胞肺癌（NSCLC）根治术后局部复发患者的预后影响因素。［方法］ 回顾性分析87例NSCLC根治术后局部复发患者的临床资料，分析局部复发部位的差异及生存情况。［结果］ 原发病灶同侧肺残端、肺门、纵隔复发（78.2%）比例远高于对侧肺门、纵隔及双侧锁骨上区（21.8%）(χ2=131.713， P=0.000)。全组患者复发后中位生存时间21.0个月，1、2、4年累积生存率分别为68.1％、44.5％和12.4%。单因素分析显示：复发间隔时间长、复发后再分期早、放化疗联合治疗以及复发后放疗剂量大于60Gy为预后有利因素， COX模型多因素分析显示仅复发后再分期为独立预后因素。［结论］ NSCLC根治术后辅助放疗应以同侧肺门及纵隔为主；对于一般情况较好、复发后再分期早的患者建议放化疗联合治疗并尽可能提高放疗剂量以进一步提高疗效。 |
| 英文摘要: |
| Abstract: ［Purpose］ To investigate the prognostic factors of local recurrence following radical surgery for non-small cell lung cancer (NSCLC) patients.［Methods］ Clinical features of 87 cases with NSCLC with local recurrence after radical resection were analyzed retrospectively， local recurrent sites and survival were analyzed. ［Results］ The recurrent rate of the ipsilateral lung stump， hilar and mediastinum lymph nodes was 78.2%，which was higher than that of the contralateral hilar， mediastinum lymph nodes and bilateral supraclavicular lymph nodes(4.6%)(χ2=131.713，P=0.000). The median survival after recurrence was 21.0 months， with 1-， 2-， 4-year cumulative survival rate 68.1%，44.5% and 12.4% respectively. Univariate analysis showed longer recurrence free interval， early re-stage after recurrence， combined chemotherapy and radiation treatment， and radiotherapy with dose≥60Gy were favorable prognostic factors. COX multivariate regression analysis showed that late re-stage after relapse was independent prognostic factor.［Conclusion］ It suggests that the main region of postoperative radiotherapy include the ipsilateralhilar and mediastinum. Combined treatment of radiotherapy and chemotherapy， and elevated radiation dose were recommended to patients with good physical condition and early re-stage after recurrence. |
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