Kono K, Murakami M, Sasaki R, Okamoto Y, Yodenn E, Kobayashi K, Kubo T, Sai H, Maetani Y, Kuroda Y
Department of Radiology, Tenri Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Jan;58(1):18-24.
We reviewed patients with intrathoracic recurrence of non-small cell lung cancer after surgery, with reference to the feasibility of radiotherapy. The series consisted of 46 patients (39 males and 7 females) treated by radiotherapy from 1982 to 1995. Histology included squamous cell carcinoma (28 patients), adenocarcinoma (17), and large cell carcinoma (1). Clinical stage by UICC classification (1987) was as follows: stage I(2 patients), stage II(1), stage IIIa(13), stage IIIb(23), and stage IV(7). Recurrences were noted in bronchial stump (18 patients) and surgical scar (4). Metastases occurred in hilar-mediastinal lymphnodes (15), lung fields (7), and pleuropericardium (2). The mean interval from surgery to recurrence was 27 months. Delivered dose ranged from 45 to 80 Gy, and 19 patients received combined chemotherapy. Therapeutic results were as follows: complete response in 16 patients, partial response in 27, no response in 12 and progressive disease in 1, Overall 2- and 5-year survival rates were 17% and 11%, respectively, and 10 months in MST. On univariate analysis, significant prognostic factors were sex, stage at recurrence, recurrence pattern, performance status and initial response to radiotherapy, while multivariate analysis showed sex and initial response. From these data, we are encouraged by effective radiotherapy for postoperative intrathoracic recurrence of non-small cell lung cancer, especially in patients with stump or lymphnode recurrence.
我们回顾了非小细胞肺癌术后胸内复发患者，参考放疗的可行性。该系列包括1982年至1995年接受放疗的46例患者（男性39例，女性7例）。组织学类型包括鳞状细胞癌（28例）、腺癌（17例）和大细胞癌（1例）。根据UICC分类（1987年）的临床分期如下：I期（2例）、II期（1例）、IIIa期（13例）、IIIb期（23例）和IV期（7例）。复发部位见于支气管残端（18例）和手术瘢痕（4例）。转移发生在肺门纵隔淋巴结（15例）、肺野（7例）和胸膜心包（2例）。从手术到复发的平均间隔时间为27个月。给予的剂量范围为45至80 Gy，19例患者接受了联合化疗。治疗结果如下：完全缓解16例，部分缓解27例，无缓解12例，疾病进展1例。总2年和5年生存率分别为17%和11%，中位生存期为10个月。单因素分析显示，显著的预后因素为性别、复发时的分期、复发模式、体能状态和对放疗最初的反应，而多因素分析显示为性别和最初的反应。从这些数据来看，我们对非小细胞肺癌术后胸内复发的有效放疗感到鼓舞，尤其是在残端或淋巴结复发的患者中。
