中国肿瘤临床与康复

目的探讨Ⅳ期非小细胞肺癌(NSCLC)化疗后行胸部原发灶精确放疗的临床疗效及意义。方法回顾性分析2011年6月至2015年12月间安徽省滁州市第一人民医院收治的60例Ⅳ期NSCLC肺外转移且无胸水者,按照随机数字表法随机分为观察组和对照组,每组30例。观察组患者接受化疗4个周期,1个月后予胸部原发灶精确放疗。对照组患者接受化疗4个周期后,不予胸部原发灶精确放疗。治疗后每个月随访,观察无进展生存时间(PFS)及中位生存时间(OS)。结果观察组患者PFS为8.5个月(6~10.6个月),对照组患者为7.0个月(6⁸.3个月),组间差异有统计学意义(P<0.05)。观察组患者中位OS为12.5个月(9.8~13.5个月),对照组为10.7个月(8.6~12.8个月),组间差异有统计学意义(P<0.05)。结论对部分Ⅳ期NSCLC化疗后予胸部原发灶精确放疗,可提高患者的PFS和OS,为Ⅳ期NSCLC选择最佳治疗方案提出新的探索思路,值得进一步研究探索。

Objective To investigate the clinical efficacy of chest primary tumor precise radiotherapy after chemotherapy for stage Ⅳ non-small cell lung cancer( NSCLC). Methods From June 2011 to December 2015 in The First People's Hospital of Chuzhou,60 Ⅳ NSCLC patients were enrolled in the study and they were randomly divided into the observation group and the control group,with 30 cases in each group. The patients in the observation group accepted 4 cycles of chemotherapy,and after 1 month primary tumor precise radiotherapy was applied. Those in the control group only accepted four cycles of chemotherapy. The progression-free survival( PFS) and overall survival( OS) were compared. Results The PFS of the observation group was 8. 5 months( 6 to 10. 6),the control group 7. 0 months( 6 to 8. 3),with significant differences( P < 0. 05). The OS of the observation group was was 12. 5 months( range 9. 8 to 13. 5),the control group 10. 7 months( range 8. 6 to 12. 8),with significant differences( P < 0. 05). Conclusion For stage Ⅳ NSCLC patients,chemotherapy combined with chest primary tumor precise radiotherapy can improve PFS and OS. And it is worthy of further study and exploration.