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目的评价和分析非小细胞肺癌根治术后残端复发的放射治疗疗效及预后因素。材料与方法从１９７０年２月至１９９３年初，３９例肺癌根治术后残端复发的病人入组分析。中位年龄５９岁，术后至复发时间３～５０月，始发复发症状至确诊时间０～２０月。伴有淋巴结转移者１８例，残端复发有组织学诊断２８例。８例加腔内放疗８～３０Ｇｙ／１～３次，２例加化疗，６例单纯腔内放疗１２～３０Ｇｙ／２～３次。单纯外照射剂量为４５～７０Ｇｙ，加腔内放疗者为２０～６０Ｇｙ。结果症状缓解率达９０％左右，５年生存率２３．０±７．５％。单纯残端复发者５年生存率３８．１±１１．０％，而伴有淋巴结转移者无３年存活（Ｐ＜０．００３）。始发复发症状至确诊时间＜２月与≥２月者，５年生存率分别为３３．７±１２．０％与１２．６±８．２％（Ｐ＞０．１０４５）。在６例行单纯腔内放疗中，２例长期生存。Ｃｏｘ回归分析仅残端复发是否伴有淋巴结转移为影响预后的重要因素。结论放射治疗是治疗非小细胞肺癌根治术后残端复发的重要手段，尤其单纯残端复发者可取得满意结果
Objective To evaluate and analyze the radiotherapy efficacy and prognostic factors of stump recurrence after radical operation of non-small cell lung cancer. Materials and Methods From February 1970 to the beginning of 1993, 39 patients with recurrent stump after radical resection of lung cancer were enrolled. The median age of 59 years, postoperative to recurrence of 3 to 50 months, the onset of recurrent symptoms to the diagnosis of 0 to 20 months. There were 18 cases with lymph node metastasis and stump recurrence with histological diagnosis of 28 cases. 8 cases received intraluminal radiotherapy 8 ~ 30Gy / 1 ~ 3 times, 2 cases plus chemotherapy, 6 cases of simple intracavitary radiotherapy 12 ~ 30Gy / 2 ~ 3 times. Pure external dose of 45 ~ 70Gy, plus intracavitary radiotherapy for 20 ~ 60Gy. Results The symptom relief rate was about 90% and the 5-year survival rate was 23.0 ± 7.5%. The 5-year survival rate of simple stump recurrence was 38.1 ± 11.0%, while those with lymph node metastasis had no 3-year survival (P <0.003). The 5-year survival was 33.7 ± 12.0% and 12.6 ± 8.2%, respectively (P> 0.1045) for patients who developed recurrence symptoms up to the time of diagnosis of <2 months and ≥ 2 months. In 6 cases of simple endovascular radiotherapy, 2 cases of long-term survival. Cox regression analysis of residual stump recurrence with lymph node metastasis is an important factor affecting the prognosis. Conclusion Radiotherapy is an important method for treatment of recurrence of stump after radical resection of non-small cell lung cancer. In particular, satisfactory results can be obtained only in stump recurrence