肺癌生存5年以上72例分析

目的]探讨影响肺癌长期生存的因素。方法对1983年1月至1992年12月间收治的经病理证实的存活5年以上的72例肺癌患者进行分析。放疗采用60Co－r线或10MV－X线，大野前后对穿照射Dr40Gy/20次，共4周后缩野加量至总DT52G6y-76Gy（平均61．6Gy，非手术者）或50Gy－70Cy（平均56．1Gy，手术者）。手术均为肺叶（段）切除术。化疗主要方案为（CTX＋5－FU＋VCR、CTX＋ADM＋DDP、CTX＋5－FU＋CBP／E－ADM＋VP-16等。结果]临床分期、病理类型和是否加用手术治疗对5年生存率的影响，分析显示有统计学差异。I、II、III、IV期5年生存率分别为42．9％、12．9％、5．8％及0；小细胞未分化癌与非小细胞癌的5年生存率分别为3．2％和96％；手术加放疗（加或不加化疗）与放疗（加或不加化疗）的5年生存率分别为对．5％和5．5％。而放疗剂量及是否加化疗对5年生存率的影响未显示有统计学差异。结论]肺癌应进行早期诊断、早期治疗，尽量采取以手术为主的综合治疗，以提高远期生存率。

An Analysis of over 5-year Survival in 72 Patients with Lung Cancer

Pupose The prognostic factors of long-tem survial were analyzed in patients with lung cancer. Methods A total of 72 patientswith pathologically proved lung cancer were enrolled in this study between january 1983 and december 1992.The conventional radiation method of fieldsanterior-posterior opposed was adopted with Cobalt60 or 10MV-X ray 40Gy/20F/weeks,then reduced the field to a total dose of 50Gy-70Gy.The poeration was pneumolobectomy.The protocols of chemotherapy were CTX 5-FU VCR,CTX ADM DDP,CTX 5-FU CBP/EAM VP-16.Results The clinical stage ,the treatment(plus operation or not )and pathologic type could affect 5-year survival rate.The statistical analysisshowed markedlly sigrificant difference(P<0.001 or P<0.05).The 5-year survival rattes in stage I,II,II and stage IV were 42.9%,12.9%,5.8% and 0,respectively.The 5-year survival rates were 20.5 % in operation group (phus radiotherapy or chemotherapy)and 5.5% in radiotherapy gronp(phus chemotherapy or not ). The 5-year survival rates were 9.6% and 3.2% in the4 NSCLC group and the SCLC group respectively. Conclusion The early diagnosis and treatment is very important for elevating the long-term survival rate. Operation is the first choice for operable lung cancer.