单纯放疗治疗的临床II期非小细胞肺癌。临床分期为同侧肺门淋巴结肿大（N1期疾病）的意义。

Clinical stage II non-small cell lung cancer treated with radiation therapy alone. The significance of clinically staged ipsilateral hilar adenopathy (N1 disease).

作者信息

Rosenthal S A, Curran W J, Herbert S H, Hughes E N, Sandler H M, Stafford P M, McKenna W G

机构信息

Department of Radiation Oncology, Fox Chase Cancer Center/University of Pennsylvania, Philadelphia.

出版信息

Cancer. 1992 Nov 15;70(10):2410-7. doi: 10.1002/1097-0142(19921115)70:10<2410::aid-cncr2820701006>3.0.co;2-4.

DOI:10.1002/1097-0142(19921115)70:10<2410::aid-cncr2820701006>3.0.co;2-4

PMID:1330280

Abstract

BACKGROUND

The prognosis of patients with clinically staged hilar nodal involvement (Stage N1) or clinical Stage II non-small cell lung cancer (NSCLC, Stage T1-2N1M0) treated with radiation therapy (RT) alone is not well established.

METHODS

Records of 758 patients with clinical Stage I-III NSCLC treated with RT were reviewed. Sixty-two patients were identified with clinical Stage II NSCLC, and 126 patients had Stage N1 disease.

RESULTS

The median survival time (MST) of the 62 patients with clinical Stage II disease was 17.9 months, with 1-year, 2-year, 3-year, and 5-year overall actuarial survival rates of 70%, 33%, 20%, and 12%, respectively. The survival of patients with clinical Stage II disease was significantly better than that of 389 patients with clinical Stage IIIA disease (MST, 11.3 months; P < 0.008) and 267 patients with clinical Stage IIIB disease (MST, 9.8 months; P = 0.0003), but it was similar to that of 40 patients with clinical Stage I lesions (MST, 15.0 months). Patients with performance statuses of 0-1 lived longer than those with a status of 2 or more (MST, 22.8 versus 6.1 months; P < 0.0001). The median survival for patients with N0, N1, N2, and N3 disease was 13.7, 12.6, 10.9, and 9.1 months, respectively. Patients with Stage N0-1 disease (MST, 13.2 months) had significantly improved MST compared with those with Stage N2-3 disease (MST, 10.3 months).

CONCLUSIONS

The survival of patients with clinical Stage II NSCLC treated with RT alone was significantly better than that of those with clinical Stage IIIA or IIIB disease. It was comparable to that of patients with clinical Stage I lesions. The clinical staging of nodal involvement limited to the ipsilateral hilum does not necessarily portend a worse prognosis than that of patients with clinical Stage N0 disease. The absence of clinically evident Stage N2-3 disease is of significant predictive value for patients with NSCLC treated with RT.

摘要

背景

单独接受放射治疗（RT）的临床分期为肺门淋巴结受累（N1期）或临床II期非小细胞肺癌（NSCLC，T1-2N1M0期）患者的预后尚未明确。

方法

回顾了758例接受RT治疗的临床I-III期NSCLC患者的记录。确定62例为临床II期NSCLC患者，126例为N1期疾病患者。

结果

62例临床II期疾病患者的中位生存时间（MST）为17.9个月，1年、2年、3年和5年的总精算生存率分别为70%、33%、20%和12%。临床II期疾病患者的生存率明显优于389例临床IIIA期疾病患者（MST，11.3个月；P<0.008）和267例临床IIIB期疾病患者（MST，9.8个月；P=0.0003），但与40例临床I期病变患者（MST，15.0个月）相似。体能状态为0-1的患者比体能状态为2或更高的患者存活时间更长（MST，22.8个月对6.1个月；P<0.0001）。N0、N1、N2和N3期疾病患者的中位生存时间分别为13.7、12.6、10.9和9.1个月。N0-1期疾病患者（MST，13.2个月）的MST明显优于N2-3期疾病患者（MST，10.3个月）。