Langendijk H, de Jong J, Wanders R, Slotman B
Department of Radiation Oncology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Clin Lung Cancer. 2001 Aug;3(1):33-6. doi: 10.3816/clc.2001.n.015.
In 1997, the International Union Against Cancer (UICC) introduced a new version of staging for lung cancer. The purpose of this study was to determine the prognostic value of the new UICC staging (1997) among patients with inoperable non-small-cell lung cancer (NSCLC) treated with radiotherapy. The status of a total of 1354 inoperable patients postintrathoracic irradiation for NSCLC was retrospectively analyzed. Restaging was performed according to the staging system of the UICC 1997. The median survival (MS) among patients with stage I disease was 12.4 months. In the case of stage IA disease, the MS was 17.6 months, which was significantly better compared to the 11.2 months observed among patients with stage IB disease (P = 0.002). The MS among patients with clinical T2 N1 M0 disease (stage IIB) was 8.0 months. The MS among those with clinical T3 N0 M0 disease (stage IIB) was 8.6 months, which was not statistically different from the group of patients with stage IIIA disease, who had an MS of 7.6 months. The MS among patients with stage IIIB disease was 6.5 months, and among patients with stage IV disease, MS was 4.0 months. It was concluded that in patients with inoperable NSCLC treated with radiotherapy, the distinction between stages IA and IB disease in the new staging system is clinically relevant. There was no significant difference in survival between patients with stage IIB and IIIA disease. The results clearly show that the prognostic significance of a staging system mainly based on surgically treated patients should be analyzed separately before it can be used among patients treated with nonsurgical modalities.
1997年，国际抗癌联盟（UICC）推出了肺癌分期的新版本。本研究的目的是确定新的UICC分期（1997年）在接受放疗的不可手术非小细胞肺癌（NSCLC）患者中的预后价值。对总共1354例因NSCLC接受胸内照射的不可手术患者的情况进行了回顾性分析。根据UICC 1997年的分期系统进行重新分期。I期疾病患者的中位生存期（MS）为12.4个月。对于IA期疾病患者，MS为17.6个月，与IB期疾病患者观察到的11.2个月相比有显著改善（P = 0.002）。临床T2 N1 M0疾病（IIB期）患者的MS为8.0个月。临床T3 N0 M0疾病（IIB期）患者的MS为8.6个月，与IIIA期疾病患者组（MS为7.6个月）无统计学差异。IIIB期疾病患者的MS为6.5个月，IV期疾病患者的MS为4.0个月。得出的结论是，在接受放疗的不可手术NSCLC患者中，新分期系统中IA期和IB期疾病的区分具有临床相关性。IIB期和IIIA期疾病患者的生存率无显著差异。结果清楚地表明，在将主要基于手术治疗患者的分期系统用于非手术治疗方式的患者之前，应单独分析其预后意义。
