Unlu Ismet, Diniz Gulden, Komurcuoglu Berna, Gayaf Mine, Gokce Tumay, Karadogan Ilker, Akcay Cimen
Department of Radiation Oncology, Izmir Oncology Center, Izmir, Turkey.
Saudi Med J. 2006 Jun;27(6):849-53.
To evaluate the efficacy of curative and palliative radiotherapy in inoperable advanced non-small cell lung cancer (NSCLC) patients with a performance status (PS) equal or greater than 2, and to compare the therapy effect on survival with or without metastatic disease.
From January 1998 through December 2004, 797 patients with inoperable stage III and IV NSCLC were treated with radiotherapy alone because of older age, cardiovascular disease, insufficient respiratory reserve or general frailty. Radical radiotherapy, consisting of approximately 60 Gy, given in 30 fractions was performed in 363 (45.5 %) of these patients. The other 434 patients (54.5%) were treated with palliative dose radiotherapy. Conventional follow-up of the patients was conducted at Izmir Oncology Center. All results were evaluated statistically.
Seven hundred and sixty-three patients (95.7%) were male. The mean age was 61.02 years (+/- 9.678), ranging from 30-88 years. The prominent histology was squamous cell carcinoma (70.7%). Sixty-five patients (8.2%) have been staged IIIA, 419 (52.6%) IIIB, and 313 (39.3%) IV. The median follow up of patients was 274.19 days. One-year survival rate was 37%, and 2-year survival rate was 11% in the radical radiotherapy group, while these rates were 20% and 5% in the others.
Although radical thoracic radiotherapy for metastatic NSCLC has not been adopted universally, this study shows that curative radiotherapy for the primary tumor provides additional survival benefit in patients with metastatic disease compared with palliative radiotherapy. This result raises the question of whether treatment with radical radiotherapy alone might be the most beneficial and cost-effective treatment of advanced stage NSCLC.
评估根治性放疗和姑息性放疗对体能状态（PS）评分为2分及以上的无法手术的晚期非小细胞肺癌（NSCLC）患者的疗效，并比较有无转移疾病时放疗对生存的治疗效果。
1998年1月至2004年12月，797例无法手术的Ⅲ期和Ⅳ期NSCLC患者因年龄较大、患有心血管疾病、呼吸储备不足或身体普遍虚弱而接受单纯放疗。其中363例（45.5%）患者接受了根治性放疗，剂量约60 Gy，分30次给予。其他434例患者（54.5%）接受了姑息性剂量放疗。患者在伊兹密尔肿瘤中心进行常规随访。所有结果均进行统计学评估。
763例患者（95.7%）为男性。平均年龄为61.02岁（±9.678），年龄范围为30 - 88岁。主要组织学类型为鳞状细胞癌（70.7%）。65例（8.2%）为ⅢA期，419例（52.6%）为ⅢB期，313例（39.3%）为Ⅳ期。患者的中位随访时间为274.19天。根治性放疗组的1年生存率为37%，2年生存率为11%，而其他组的这些比率分别为20%和5%。
虽然转移性NSCLC的根治性胸部放疗尚未被普遍采用，但本研究表明，与姑息性放疗相比，对原发性肿瘤进行根治性放疗可为有转移疾病的患者提供额外的生存益处。这一结果引发了一个问题，即单纯采用根治性放疗是否可能是晚期NSCLC最有益且最具成本效益的治疗方法。
