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目的:探讨ⅢA-N2期非小细胞肺癌(NSCLC)完全切除术后三维适形放疗联合辅助化疗疗效。方法:对48例ⅢA-N2期NSCLC完全切除术后患者,术后病理为腺癌18例、鳞癌27例、腺鳞癌3例,按信封法随机分为放疗组(24例)与非放疗组(24例)。放疗组采用术后三维适形放疗,4~5个非共面野,以90%~95%等剂量曲线包绕PTV,每次2 Gy,1次/日,5次/周,共照射25次,总剂量DT 50 Gy,放疗后予TP方案化疗3~4周期;非放疗组术后予TP方案化疗3~4周期。结果:放疗组1、2、3年生存率分别为95.8%、79.2%、62.5%,非放疗组分别为91.7%、58.3%、37.5%;放疗组1、2、3年无病生存率分别75.0%、58.3%、45.8%,非放疗组分别为54.2%、41.7%、25.0%;放疗组与非放疗组3年胸腔内复发分别12.5%和37.5%;放疗组与非放疗组中位生存时间分别为28个月和18个月;放疗组白细胞减少、急性放射性肺炎、气管炎发生率分别为25.0%、8.3%、12.5%,均为Ⅰ或Ⅱ级;Ⅰ级急性放射性食管炎发生率为20.8%。结论:ⅢA-N2期非小细胞肺癌完全切除术后三维适形放疗联合辅助化疗,可以降低患者胸腔内肿瘤复发、提高术后生存率。
Objective: To investigate the effect of three-dimensional conformal radiotherapy combined with adjuvant chemotherapy after complete resection of stage ⅢA-N2 non-small cell lung cancer (NSCLC). Methods: Forty-eight patients with stage ⅢA-N2 NSCLC were divided into radiotherapy group (24 cases) and non-squamous cell carcinoma group Radiotherapy group (24 cases). The radiotherapy group was treated with three-dimensional conformal radiotherapy and 4 to 5 non-coplanar radiographs. Each dose of PTV was infused in a dose of 90% -95% at a dose of 2 Gy, once daily, 5 times a week for a total of 25 Times, the total dose of DT 50 Gy, after radiotherapy to TP regimen chemotherapy 3 to 4 cycles; non-radiotherapy group after TP regimen chemotherapy 3 to 4 cycles. Results The 1, 2, 3-year survival rates of radiotherapy group were 95.8%, 79.2% and 62.5% respectively, and 91.7%, 58.3% and 37.5% in non-radiotherapy group respectively. The 1, 2 and 3-year disease- 75.0%, 58.3% and 45.8% respectively. The non-radiotherapy group was 54.2%, 41.7% and 25.0% respectively. The three-year recurrence rate was 12.5% and 37.5% respectively in radiotherapy group and non-radiotherapy group. The median survival rate The incidences of leukopenia, acute radiation pneumonitis and bronchitis were 25.0%, 8.3% and 12.5% in radiotherapy group, all of which were grade Ⅰ or Ⅱ. The incidence of grade Ⅰ acute radiation esophagitis 20.8%. Conclusion: Three-dimensional conformal radiotherapy combined with adjuvant chemotherapy after complete resection of stage ⅢA-N2 non-small cell lung cancer can reduce the recurrence and improve the postoperative survival rate in patients with intrathoracic tumor.