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目的回顾性分析原发灶≥５ｃｍ的非小细胞肺癌放疗疗效及影响预后因素。材料与方法自１９７４年１月～１９８８年１２月共收治原发灶可测量、最小径≥５ｃｍ的非小细胞肺癌２７８例，男２３５例，女４３例。全部有组织学证实。Ⅰ期５例，Ⅱ期３７例，ⅢＡ期１７５例，ⅢＢ期６１例，伴有空洞４２例。照射方法采用６０Ｃｏ或８ＭＶ－Ｘ线外照射，常规前后野照射４０Ｇｙ／４周，然后避开脊髓缩野加量２０～３０Ｇｙ／２～３周。结果１，３，５年生存率分别为５１．０％，９．３％和５．０％。原发灶５ｃｍ×５ｃｍ～６ｃｍ×７ｃｍ和７ｃｍ×７ｃｍ～１０ｃｍ×１２ｃｍ的３，５年生存率分别为１１．６％，６．０％和３．８％，２．５％。Ⅰ，Ⅱ和Ⅲ期的３，５年生存率分别为８０．０％，６０．０％和１８．０％，１０．０％和６．０％，３．０％。空洞和非空洞３，５年生存率分别为２．４％，２．４％和１０．６％，５．０％。结论肿瘤≥５ｃｍ的情况下，肿瘤大小与空洞发生率无明显关系，预后与原发灶大小关系不大，而与临床分期、局部是否控制有关
Objective To retrospectively analyze the radiotherapy efficacy and prognostic factors of non-small cell lung cancer (NSCLC) with primary tumor≥5cm. Materials and Methods From January 1974 to December 1988, a total of 278 non-small-cell lung cancers with measurable primary lesions with a diameter of ≥5cm were treated. There were 235 males and 43 females. All confirmed by histology. There were 5 cases in stage I, 37 cases in stage II, 175 cases in stage IIIA, 61 cases in stage IIIB, and 42 cases with cavitation. Irradiation methods were 60Co or 8MV-X external irradiation, conventional field irradiation before and after 40Gy / 4 weeks, and then avoid the spinal cord shrinkage of 20 ~ 30Gy / 2 to 3 weeks. Results The 1-, 3-, and 5-year survival rates were 51.0%, 9.3%, and 5.0%, respectively. The 3 and 5-year survival rates of primary lesions 5cm×5cm to 6cm×7cm and 7cm×7cm to 10cm×12cm were 11.6%, 6.0% and 3.8%, 2.5%, respectively. The 3-year and 5-year survival rates for stage I, II and III were 80.0%, 60.0% and 18.0%, 10.0% and 6.0%, and 3.0%, respectively. The 3- and 5-year survival rates for voids and non-voids were 2.4%, 2.4%, 10.6%, and 5.0%, respectively. Conclusion In the case of tumor ≥ 5cm, there is no obvious relationship between the tumor size and the incidence of cavitation. The prognosis is not related to the size of the primary tumor, but is related to the clinical stage and local control.