Zhang H X, Yin W B, Zhang L J, Yang Z Y, Zhang Z X, Wang M, Chen D F, Gu X Z
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Radiother Oncol. 1989 Feb;14(2):89-94. doi: 10.1016/0167-8140(89)90052-2.
The results of 44 patients with early operable non-small cell lung cancer treated from January 1975 through 1981 are retrospectively analysed. All were proven by pathology and/or cytology and denied surgery in our joint Chest Clinic for various reasons. 55-70 Gy/6-7 weeks was delivered by conventional fractionation through A-P portals by telecobalt and/or 25-35 MeV high energy electron beam or 8 MV X-ray. 40 Gy/4 weeks was given prophylactically to the mediastinum. The 1-, 3-, and 5-year survival rates, 93, 55, and 32%, are superior to what is reported in the literature. In the present series, the favorable factors are: (1) patients without any intercurrent disease but refused operation; (2) T1 lesions; (3) complete regression of the lesion at the conclusion of radiotherapy; (4) doses ranging from 69 to 70 Gy. It is shown that early non-small cell lung cancer can be cured by radiotherapy alone giving survival rates comparable to surgery. Prospective randomized clinical trials are warranted.
对1975年1月至1981年期间接受治疗的44例早期可手术非小细胞肺癌患者的结果进行了回顾性分析。所有病例均经病理和/或细胞学证实，因各种原因在我们的联合胸部诊所被拒绝手术。通过远距离钴和/或25 - 35 MeV高能电子束或8 MV X射线经前后野以常规分割方式给予55 - 70 Gy/6 - 7周剂量。预防性地给予纵隔40 Gy/4周剂量。1年、3年和5年生存率分别为93%、55%和32%，优于文献报道。在本系列中，有利因素为：(1)无任何并发疾病但拒绝手术的患者；(2) T1期病变；(3)放疗结束时病变完全消退；(4)剂量范围为69至70 Gy。结果表明，早期非小细胞肺癌单纯放疗可治愈，生存率与手术相当。有必要进行前瞻性随机临床试验。
