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目的 :分析同步放化疗(CRT)在NSCLC外科治疗的地位。方法 :回顾性总结 1987～1996年外科手术的 3 0例累及胸顶部的NSCLC ,单纯手术组 10例 ,手术 +放疗组 (RT) 9例 ,含铂方案化疗 +放疗组 (CRT) 11例。结果 :单纯手术组 2、4年生存率分别为 3 0 %和 2 0 % ,RT组为 2 2 %和 11% ,CRT组为 73 %和 5 3 %。单因素分析根治性 (是与否比较 ,P =0 0 2 7)和诱导性治疗 (单纯手术和RT与CRT比较 ,P =0 0 173 )是有意义的预后因素。多因素分析仅诱导性治疗 ,P =0 0 2 3 8,是有意义的预后因素。结论 :与诱导性放疗和单纯手术相比 ,CRT可提高累及胸顶部的NSCLC患者的生存率。
Objective: To analyze the status of concurrent chemoradiotherapy (CRT) in surgical treatment of NSCLC. Methods: Thirty cases of NSCLC involving thoracic top were retrospectively reviewed. Totally 10 cases were treated with surgery alone, 9 cases were treated with radiotherapy (RT) and 11 cases were treated with platinum regimen plus radiotherapy (CRT). RESULTS: The 2-year and 4-year survival rates were 30% and 20% in the surgery alone group, 22% and 11% in the RT group, 73% and 53% in the CRT group, respectively. Univariate analysis of the radical (yes vs no, p = 0.027) and induction therapy (simple surgery vs RT vs CRT, P = 0 0 173) were significant prognostic factors. Multivariate analysis was only induction therapy, P = 0 0 2 3 8, which was a significant prognostic factor. CONCLUSIONS: CRT improves the survival of patients with NSCLC that involve the top of the chest compared with induction radiotherapy and surgery alone.