Graham P H, Gebski V J, Langlands A O
Department of Radiation Oncology, Westmead Hospital, NSW, Australia.
Int J Radiat Oncol Biol Phys. 1995 Jan 15;31(2):261-6. doi: 10.1016/0360-3016(94)E0137-9.
To evaluate the results of a departmental treatment policy in a consecutive series of patients with nonsmall cell carcinoma of the lung. A second purpose was to estimate the survival of patients treated with radical intent. A third purpose was to estimate the impact of comorbidity on the selection of patients for treatment and on its outcome.
The records of 720 consecutive patients referred to a single Department of Radiation Oncology between 1979 and 1985 were reviewed. One hundred fifty patients with early stage (Stage I and II disease) were studied in detail and the results are presented for the outcome of 103 patients treated by radical radiotherapy. All patients were followed for a minimum period of five years or until death.
Patients referred for radiation therapy were elderly and usually had squamous cell carcinoma of the lung. Comorbidity was significant as was weight loss which occurred in a third of patients. The overall survival of patients treated with radical intent was 13%. In a small subgroup of patients with T1 tumors without weight loss and aged under 70 survival reached 50% at 5 years with no treatment-related mortality and with insignificant treatment-related morbidity.
Highly selected subsets of patients suitable for treatment with radiotherapy can be defined equally as well as highly selected subsets of patients can be selected for surgery. Treatment outcome can be surprisingly good in these subsets indicating that the treatment of nonsmall cell lung cancer, particularly in older patients without comorbidity should not automatically be by a surgical approach.
评估某科室针对一系列连续的非小细胞肺癌患者的治疗策略效果。第二个目的是估计接受根治性治疗患者的生存率。第三个目的是评估合并症对患者治疗选择及其预后的影响。
回顾了1979年至1985年间转诊至单一放射肿瘤学科室的720例连续患者的记录。对150例早期（I期和II期疾病）患者进行了详细研究，并给出了103例接受根治性放疗患者的结果。所有患者均随访至少五年或直至死亡。
接受放射治疗的患者年龄较大，通常患有肺鳞状细胞癌。合并症较为显著，三分之一的患者出现体重减轻。接受根治性治疗患者的总生存率为13%。在一小部分T1肿瘤、无体重减轻且年龄在70岁以下的患者中，5年生存率达到50%，无治疗相关死亡率，治疗相关发病率也不显著。
可以确定出与适合手术治疗的高度选择患者亚组一样明确的适合放疗的高度选择患者亚组。这些亚组的治疗效果可能出奇地好，这表明非小细胞肺癌的治疗，尤其是在无合并症的老年患者中，不应自动采用手术方法。
