546例Ⅳ期非小细胞肺癌远处转移特点的放疗意义分析

doi:10.3760/cma.j.issn.1004-4221.2012.02.008

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摘要目的分析初诊临床Ⅳ期非小细胞肺癌的远处转移特点,为局部三维放疗可能性提供参考。方法回顾分析 546例临床Ⅳ期非小细胞肺癌初诊时远处转移器官、病灶部位、数目等特点,以及肿瘤分期对远处转移率的影响。结果 546例患者中骨、脑、肺、肝、肾上腺、远处淋巴结、皮下、其他器官转移分别为294、167、137、79、66、37、35、10例。单器官转移 379例,其中骨、脑、肺、肝、肾上腺、远处淋巴结、皮下、其他器官转移分别占37.7%、19.8%、16.9%、7.4%、7.4%、4.5%、5.5%、0.8%。T₃₊₄期骨转移率与T₁₊₂期的差异无统计学意义(69.4%、30.6%,χ²=7.65,P=0.067),而N₂₊₃的显著高于N₀₊₁(69.7%、30.3%,χ²=7.89,P=0.044)。T₃₊₄期脑转移率显著高于T₁₊₂期的(70.7%、29.3%,χ²=10.64,P=0.018),而N₂₊₃期与N₀₊₁期的差异无统计学意义(54.5%、45.5%,χ²=7.14,P=0.079),但N₁₊₂₊₃期的显著高于N₀期的(86.8%、13.2%,χ²=10.26,P=0.024)。结论 Ⅳ期非小细胞肺癌初诊时远处转移率由高到低依次为骨、脑、肺、肝、肾上腺和其他器官并以单器官多见;局部病灶分期越晚远处转移率越高;提示三维放疗技术可用于改善部分Ⅳ期NSCLC患者生活质量并延长生存时间。

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	李凤虎
	卢冰
	付和谊
	韩蕾
	李青松
	栗惠芹

关键词 ：癌, 非小细胞肺, 肿瘤转移, 放射疗法, 三维

Abstract：Objective To investigate the clinical metastasis features and the possibility of 3 dimensional radiotherapy of stage Ⅳ non-small cell lung cancer (NSCLC). Methods The clinical materials of 546 patients with stage Ⅳ NSCLC and the relationship b T and N stage and metastasis were retrospectively analyzed. Results In 546 patients with stage ⅣNSCLC, the number with bone metastasis was 294, the number with brain metastasis was 167, the number with lung metastasis was 137, the number with liver metastasis was 79,the number with adrenal gland metastasis was 66, 37 with lymph node metastasis, 35 with subcutaneous metastasis and 10 with other organ metastasis. The number with single organ metastasis was 379(69.4%),in which 37.7% with bone metastasis,19.8% with brain metastasis,16.9% with lung metastasis,7.4% with liver metastasis,7.4% with adrenal gland metastasis,4.5% with lymph node metastasis,5.5% with subcutaneous metastasis and 0.8% with other organ metastasis. The bone metastasis probability of T₃₊₄ patient was similar with T₁₊₂(69.4%,30.6%,χ²=7.65,P=0.067),but N₂₊₃ patient was more than N₀₊₁(69.7%,30.3%,χ²=7.89,P=0.044).The brain metastasis probability of T₃₊₄ patient was more than T₁₊₂(70.7%,29.3%,χ²=10.64,P=0.018),but N₂₊₃ patient was similar with N₀₊₁(54.5%,45.5%,χ²=7.14,P=0.079),and N₁₊₃₊₃ patient was more than N₀(86.8%,13.2%,χ²=10.26,P=0.024). Conclusions In 546 patients with stage ⅣNSCLC, the most common metastatic organ is bone, the second is brain, the third is lung, the forth is liver, followed by adrenal gland;single organ metastasis is more common than multiple organ metastasis. The later the T stage is, the more severe is the metastasis. Through 3 dimensional radiotherapy, not only the quality of life of some stage Ⅳ patients is improved, but also the survival time was prolonged observably.

Key words： Carcinoma, non-small lung Neoplasm metastasis Radiotherapy, three-dimensional

收稿日期: 2011-06-21

基金资助:贵州省科技攻关项目(黔科合SY\[2010\]3078号)

引用本文:

李凤虎,卢冰,付和谊等. 546例Ⅳ期非小细胞肺癌远处转移特点的放疗意义分析[J]. 中华放射肿瘤学杂志, 2012, 21(2): 122-125.

LI Feng-hu,LU Bing,FU Fe-yi et al. Metastasis features of 546 patients with stage Ⅳ non-small cell lung cancer at first visit and the significance in radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(2): 122-125.

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