Noordijk E M, vd Poest Clement E, Hermans J, Wever A M, Leer J W
Department of Clinical Oncology (Division of Radiotherapy), University Hospital, Leiden, The Netherlands.
Radiother Oncol. 1988 Oct;13(2):83-9. doi: 10.1016/0167-8140(88)90029-1.
From 1978 to 1983, 50 patients with a peripherally located non-small cell tumor of the lung were irradiated with curative intent. These patients were not operated upon because of poor cardiac or pulmonary condition, old age or refusal to operate. Mean age was 74 years, 40 patients being over 70 years of age. All patients had T1-2 N0M0 tumors according to the AJC classification and received 60 Gy to the primary tumor only. The overall response rate was 90%, with 50% complete responses in tumors smaller than 4 cm. The crude overall survival rates were 56% at 2 years and 16% at 5 years, with a median survival of 27 months. Age did not influence survival. There was a strong correlation of survival to tumor size, with 5-year survival rates of 38, 22, 5 and 0% in tumors with diameters of less than or equal to 2, 2-3, 3-4 and greater than 4 cm respectively. Only 5 out of 20 complete responders had a local recurrence, the 5-year survival in this group was 42%. These results compared favorably to a group of 86 patients over 70 years of age who were selected for operation in the same hospital. The 2- and 5-year survival rates in these patients were 48 and 26% respectively, median survival being 23 months. We conclude that in patients over 70 years of age with resectable lung cancer, radiotherapy with curative intent should be offered as an alternative to operation, especially if the tumor is not larger than 4 cm.(ABSTRACT TRUNCATED AT 250 WORDS)
1978年至1983年期间，对50例患有周围型非小细胞肺癌的患者进行了根治性放疗。这些患者因心脏或肺部状况不佳、年龄较大或拒绝手术而未接受手术。平均年龄为74岁，其中40例患者年龄超过70岁。根据美国癌症联合委员会（AJC）分类，所有患者均为T1-2 N0M0肿瘤，仅对原发肿瘤给予60 Gy的照射剂量。总缓解率为90%，肿瘤小于4 cm的患者完全缓解率为50%。2年的粗总生存率为56%，5年为16%，中位生存期为27个月。年龄不影响生存率。生存率与肿瘤大小密切相关，直径小于或等于2 cm、2-3 cm、3-4 cm和大于4 cm的肿瘤5年生存率分别为38%、22%、5%和0%。20例完全缓解者中只有5例出现局部复发，该组5年生存率为42%。这些结果优于在同一家医院选择接受手术的86例70岁以上患者。这些患者的2年和5年生存率分别为48%和26%，中位生存期为23个月。我们得出结论，对于70岁以上可切除肺癌患者，应提供根治性放疗作为手术的替代方案，特别是如果肿瘤不大于4 cm。（摘要截断于250字）
