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目的探讨Ⅳ期非小细胞肺癌(NSCLC)化疗后行胸部原发灶精确放疗的临床疗效及意义。方法回顾性分析2011年6月至2015年12月间安徽省滁州市第一人民医院收治的60例Ⅳ期NSCLC肺外转移且无胸水者,按照随机数字表法随机分为观察组和对照组,每组30例。观察组患者接受化疗4个周期,1个月后予胸部原发灶精确放疗。对照组患者接受化疗4个周期后,不予胸部原发灶精确放疗。治疗后每个月随访,观察无进展生存时间(PFS)及中位生存时间(OS)。结果观察组患者PFS为8.5个月(6~10.6个月),对照组患者为7.0个月(6~8.3个月),组间差异有统计学意义(P<0.05)。观察组患者中位OS为12.5个月(9.8~13.5个月),对照组为10.7个月(8.6~12.8个月),组间差异有统计学意义(P<0.05)。结论对部分Ⅳ期NSCLC化疗后予胸部原发灶精确放疗,可提高患者的PFS和OS,为Ⅳ期NSCLC选择最佳治疗方案提出新的探索思路,值得进一步研究探索。
Objective To investigate the clinical efficacy and significance of precise radiotherapy of primary thoracic cavity after chemotherapy of stage Ⅳ non-small cell lung cancer (NSCLC). Methods A retrospective analysis of 60 patients with stage Ⅳ NSCLC who had no extracapsular fluid admitted from First People’s Hospital of Chuzhou City, Anhui Province from June 2011 to December 2015 were randomly divided into observation group and control group according to random number table , 30 cases in each group. Patients in the observation group received 4 cycles of chemotherapy, and after 1 month, they were given accurate radiotherapy to the primary chest. Patients in the control group received 4 cycles of chemotherapy without radiotherapy of the chest. Every month after follow-up, the progression-free survival time (PFS) and median survival time (OS) were observed. Results The PFS of the observation group was 8.5 months (range, 6 to 10.6 months), while the control group was 7.0 months (range, 6 to 8.3 months). There was significant difference between the two groups (P <0.05). The median OS was 12.5 months (9.8 ~ 13.5 months) in the observation group and 10.7 months (8.6-12.8 months) in the control group. The difference between the two groups was statistically significant (P <0.05). Conclusions Precise radiotherapy of primary breast cancer after partial Ⅳ NSCLC chemotherapy can improve the PFS and OS of patients, and put forward new exploration ideas for selecting the best treatment for stage Ⅳ NSCLC. It is worth further study and exploration.