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Prospective Trial of Stereotactic Body Radiation Therapy for Both Operable and Inoperable T1N0M0 Non-Small Cell Lung Cancer: Japan Clinical Oncology Group Study JCOG0403.立体定向体部放疗治疗可手术和不可手术 T1N0M0 期非小细胞肺癌的前瞻性研究:日本临床肿瘤学组研究 JCOG0403。
Int J Radiat Oncol Biol Phys. 2015 Dec 1;93(5):989-96. doi: 10.1016/j.ijrobp.2015.07.2278. Epub 2015 Nov 11.
2
Comparative effectiveness of 5 treatment strategies for early-stage non-small cell lung cancer in the elderly.比较 5 种治疗策略在老年早期非小细胞肺癌中的疗效。
Int J Radiat Oncol Biol Phys. 2012 Dec 1;84(5):1060-70. doi: 10.1016/j.ijrobp.2012.07.2354. Epub 2012 Sep 11.
3
Safety and prognosis of limited surgery for octogenarians with non-small-cell lung cancer.八旬非小细胞肺癌患者有限手术的安全性及预后
Gen Thorac Cardiovasc Surg. 2012 Feb;60(2):97-103. doi: 10.1007/s11748-011-0880-3. Epub 2012 Feb 12.
4
Preliminary report of late recurrences, at 5 years or more, after stereotactic body radiation therapy for non-small cell lung cancer.立体定向体部放疗治疗非小细胞肺癌 5 年以上后迟发复发的初步报告。
J Thorac Oncol. 2012 Feb;7(2):453-6. doi: 10.1097/JTO.0b013e31823c5b29.
5
Efficacy of functional operability algorithm for octogenarians with primary lung cancer.功能可操作性算法对老年原发性肺癌患者的疗效
Gen Thorac Cardiovasc Surg. 2012 Jan;60(1):36-42. doi: 10.1007/s11748-011-0842-9. Epub 2012 Jan 13.
6
Lobectomy in octogenarians with non-small cell lung cancer: ramifications of increasing life expectancy and the benefits of minimally invasive surgery.八十岁以上非小细胞肺癌患者的肺叶切除术:预期寿命延长的影响因素和微创手术的获益。
Ann Thorac Surg. 2011 Dec;92(6):1951-7. doi: 10.1016/j.athoracsur.2011.06.082. Epub 2011 Oct 7.
7
A model for morbidity after lung resection in octogenarians.八旬老人肺切除术后发病率模型。
Eur J Cardiothorac Surg. 2011 Jun;39(6):989-94. doi: 10.1016/j.ejcts.2010.09.038. Epub 2011 Jan 26.
8
Impact of introducing stereotactic lung radiotherapy for elderly patients with stage I non-small-cell lung cancer: a population-based time-trend analysis.立体定向放疗对Ⅰ期老年非小细胞肺癌患者的影响:基于人群的时间趋势分析。
J Clin Oncol. 2010 Dec 10;28(35):5153-9. doi: 10.1200/JCO.2010.30.0731. Epub 2010 Nov 1.
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Stereotactic radiotherapy reduces treatment cost while improving overall survival and local control over standard fractionated radiation therapy for medically inoperable non-small-cell lung cancer.立体定向放疗可降低治疗成本,同时提高不能手术的非小细胞肺癌的整体生存率和局部控制率,优于标准分割放疗。
Am J Clin Oncol. 2011 Oct;34(5):494-8. doi: 10.1097/COC.0b013e3181ec63ae.
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Systematic classification of morbidity and mortality after thoracic surgery.胸外科术后发病率和死亡率的系统分类。
Ann Thorac Surg. 2010 Sep;90(3):936-42; discussion 942. doi: 10.1016/j.athoracsur.2010.05.014.

评估接受肺叶切除术的八旬老人的生存率及并发症严重程度分级

Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy.

作者信息

Feczko Andrew, McKeown Elizabeth, Wilson Jennifer L, Louie Brian E, Aye Ralph W, Gorden Jed A, Vallières Eric, Farivar Alexander S

机构信息

Division of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USA.

Surgical Specialists of Charlotte, 2001 Vail Ave., Suite 320, Charlotte, NC 28207, USA.

出版信息

Can Respir J. 2017;2017:6294895. doi: 10.1155/2017/6294895. Epub 2017 Feb 8.

DOI:10.1155/2017/6294895
PMID:28270738
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5320296/
Abstract

Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. . We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. . 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. . In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer.

摘要

八旬老人肺切除术后并发症风险增加。鉴于存在放疗等替代方案,了解手术风险及相关生存率很有价值。目前缺乏对该人群并发症严重程度及长期生存情况进行分级的数据。我们回顾了我们在八旬老人肺叶切除方面的经验,使用经过验证的胸科发病率和死亡率模式对并发症进行分级。我们回顾性分析了2004年至2012年间连续接受肺叶切除术的年龄≥80岁的患者。收集了人口统计学资料、临床/病理分期、并发症、复发情况及死亡率。并发症根据Seely胸科发病率和死亡率模型进行分级。对45例患者(平均年龄82.2岁)进行了分析。大多数患者(28/45,62%)为临床IA/IB期。62%(28/45)的患者出现了并发症。根据Seely模型,只有15.6%(7/45)的患者被认为有严重病态(≥IIIB级)。围手术期死亡率为2%,半数患者在53个月的随访时仍存活。总体五年生存率为52%。在经过精心挑选的八旬老人中,肺叶切除术的严重病态并发症发生率为15.6%,总体生存率令人鼓舞。这些数据为与患者就肺癌肺叶切除术进行更全面的讨论提供了依据。