The Role of Radiotherapy for Advanced Non-Small Cell Lung Cancer

胸腔放射治療無法提昇晚期非小細胞肺癌之存活率

邱世哲(Shih-Che Chiu) ； 張國華(Kou-Hwa Chang) ； 陳裕仁(Yu-Jen Chen) ； 鍾昌宏(Chang-Hung Chung) ； 賴允亮(Yuen-Liang Lai) ； 吳孟浩(Meng-Hao Wu)

《放射治療與腫瘤學》 5卷4期 (1998/12) Pp. 277-283

https://doi.org/10.6316/TRO/199805(4)277

摘要

目的：評估放射治療對於晚期非小細胞肺癌病人之適當性。
材料與方法：共有89名病患於1992年7月至1997年6間到馬偕紀念醫院求診。其中63位曾接受放射治療，另外23位則否。對於第三期之病患將給予胸腔放射治療，而第四期之病患則只針對轉移部位或引起之症狀給予放射治療。
結果：相對於沒有接受放射治療的病人比較起來，晚期非小細胞肺癌病人接受放射治療並沒有存活率增加之優點。
結論：胸腔放射治療並不能增加晚期非小細胞肺癌病人之存活率。

關鍵字

存活率 ； 放射治療 ； 晚期非小細胞肺癌

並列摘要

Purpose: To re-evaluate the appropriateness of thoracic radiotherapy (AT) for patients with advanced non-small coil lung cancer (NSCLC).
Materials and Methods: This retrospective study included 89 patients with advanced NSCLC registered in Mackay Memorial Hospital from July 1992 to Juno 1997. Thoracic RT was given with radical or palliative intent depending on the stage and/or performance status at diagnosis to 63 (the AT group) but had withheld in 26 (the non-AT group). The total dose to the primary tumor was in the range of 5000-6000 cGy at 180 cGy per fraction over 5-6.5 weeks. Tumor control was strictly defined as complete disappearance of tumor on all radiographic examinations and/or no evidence of disease clinically at the last follow up.
Results: No survival advantage was noted in the AT group compared to the non-AT group (median 3.0 vs. 5.5 months). The mean survival time of patients with stage Ill disease was 11.37 ± 1.94 months and median survival time was 8 months. The control rate in the AT group was poor with only 4 of 63 (6%) disease-free on the last follow up. One of four patients who were disease-free died of radiation pneumonitis about 3 months after complete of AT. In addition, one patient with stage lllb was still alive, undergoing chemotherapy for distant metastasis.
Conclusion: Thoracic RT did not prolong survival for patients with locally advanced NSCLC.

並列關鍵字

Survival ； Radiotherapy ； Advanced non-small cell lung cancer