诱导性同步放化疗治疗侵袭性肺上沟瘤

目的分析同步放化疗(CRT)在NSCLC外科治疗的地位.方法回顾性总结1987～1996年外科手术的30例累及胸顶部的NSCLC,单纯手术组10例,手术+放疗组(RT)9例,含铂方案化疗+放疗组(CRT)11例.结果单纯手术组2、4年生存率分别为30%和20%,RT组为22% 和11%,CRT组为73% 和53%.单因素分析根治性(是与否比较,P=0.027)和诱导性治疗(单纯手术和RT与CRT比较,P=0.0173)是有意义的预后因素.多因素分析仅诱导性治疗,P=0.0238,是有意义的预后因素.结论与诱导性放疗和单纯手术相比,CRT可提高累及胸顶部的NSCLC患者的生存率.

Induction concurrent chemoradiation therapy for invading apical lung cancer

OBJECTIVE:Although non-small cell lung cancer(NSCLC)involving the superior sulcus has been generally treated with radiation therapy(RT)followed by surgery,local recurrence is still a big problem to be solved.We investigated a role of induction therapy,especially induction concurrent chemoradiation therapy(CRT),on the surgical results of this type of NSCLC.METHODS:We retrospectively reviewed 30 patients with NSCLC invading the apex of the chest wall who underwent surgery from 1987 to 1996.Ten patients(57±8 years)received surgery alone,9(55±13 years)received RT(42±7 Gy)followed by surgery and 11(51±9 years)received cisplatin based chemotherapy and RT(47±5 Gy)as an induction therapy.RESULTS:Two and 4-year survival rates were 30% and 20% in patients with surgery alone,22% and 11% in patients with induction RT,and 73% and 53% in patients with induction CRT,respectively.The survival was significantly better in patients with induction CRT than those with induction RT or surgery alone.Univariate analysis demonstrated that curability(yes versus no:P=0.027)and induction therapy(surgery alone and RT versus CRT:P=0.017 3)were significant prognostic factors.Multivariate analysis revealed that only induction therapy,P=0.023 8 was a significant prognostic factor.CONCLUSIONS:Induction CRT seems to improve the survival in patients with NSCLC invading the apex of the chest wall compared with induction RT or surgery alone.