| 吴晴,董百强,金佳男,杭青青,刘晓慧,徐裕金,陈明.非小细胞肺癌术后肺内复发灶立体定向放疗与手术的疗效比较[J].中华放射医学与防护杂志,2022,42(11):857-864 |
| 非小细胞肺癌术后肺内复发灶立体定向放疗与手术的疗效比较 |
| Comparison of the efficacy of stereotactic body radiotherapy and surgery for intrapulmonary recurrence patients after non-small cell lung cancer surgery |
| 投稿时间：2022-07-02 |
| DOI：10.3760/cma.j.cn112271-20220702-00277 |
| 中文关键词: 非小细胞肺癌 体部立体定向放射治疗 手术治疗 肺内复发 |
| 英文关键词:Non-small cell lung cancer Stereotactic body radiation therapy Surgical treatment Intrapulmonary recurrence |
| 基金项目:浙江省医药卫生科技项目(2020KY079);北京希思科领航肿瘤研究项目(Y-2019AZMS-0061);北京科创医学发展基金会项目(KC2021-JX-0186-63) |
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| 中文摘要: |
| 目的 对比立体定向放疗(SBRT)和手术治疗非小细胞肺癌(NSCLC)根治术后肺内复发的疗效。方法 回顾性分析中国科学院大学附属肿瘤医院2012年11月至2018年12月,NSCLC患者接受根治性手术后出现肺内复发而接受SBRT或再次手术的病例。Kaplan-Meier法计算生存结局,Log-rank法进行组间对比,Cox回归法进行单因素和多因素分析。结果 共62例患者符合条件,33例接受SBRT,29例接受再次手术。两组患者中位随访时间分别为45.8和37.4个月。SBRT和手术患者的3年局部区域控制率(LRCR)分别为79.8% vs. 90.2%(P＞ 0.05);无进展生存期(PFS)分别为58.5% vs. 42.3%(P＞ 0.05);总生存期(OS)分别为78.0% vs. 85.5%(P＞ 0.05)。多因素分析提示,治疗方式、查尔森指数(CCI)、辅助药物治疗为PFS的独立预后因素(P=0.027、0.013、0.001)。结论 对于NSCLC根治术后肺内复发的患者,SBRT与手术的疗效相当。 |
| 英文摘要: |
| Objective To compare the efficacy of stereotactic body radiotherapy(SBRT) and surgery in treating intrapulmonary recurrence of non-small cell lung cancer (NSCLC) after radical surgery.Methods A retrospective analysis was conducted on NSCLC patients, who underwent radical surgery at the Cancer Hospital Affiliated to University of Chinese Academy of Sciences from November 2012 to December 2018 and then received SBRT or secondary surgery because of postoperative intrapulmonary recurrence. The survival rates of these patients were calculated using the Kaplan-Meier method. The comparison between the two groups was made using the Log-rank method, and the univariate and multivariate analysis was made using the Cox regression method.Results Among 62 eligible patients, 33 received SBRT and 29 received secondary surgery, and they were divided into the SBRT group and the surgery group accordingly. For the SBRT and surgery groups, the median follow-up time was 45.8 months and 37.4 months, the 3-year locoregional control rate (LRCR) 79.8% and 90.2%, respectively (P ＞ 0.05), the progression-free-survival (PFS) 58.5% and 42.3%, respectively (P ＞0.05), and the overall survival (OS) 78.0% and 85.5%, respectively (P ＞0.05). The multivariate analysis suggested that treatment method, Charlson comorbidity index (CCI), and adjuvant drug therapy were independent prognostic factors for PFS (P = 0.027, 0.013, 0.001).Conclusions The efficacy of SBRT and surgery is comparable for patients with intrapulmonary recurrence of NSCLC after radical surgery. |
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