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目的探讨胸部精确放疗对Ⅳ期非小细胞肺癌(NSCLC)寡转移患者的临床疗效。方法经病理确诊并完成4个周期含铂方案化疗后达疾病控制的初诊Ⅳ期NSCLC寡转移患者86例,随机均分为两组:化疗组接受观察或继续化疗1~2个疗程;放化组接受胸部累及野照射精确放疗,后观察或继续化疗1~2个疗程。观察临床有效率、疾病控制率及1、2、3年生存率、胸部症状发生情况及放化疗不良反应。结果化疗组和放化组分别接受继续化疗共56和50个疗程。放化组有效率、疾病控制率及1、2、3年生存率均高于化疗组(P<0.05)。放化组咳痰/喘鸣、胸壁疼痛症状低于化疗组(P<0.05)。放化疗不良反应多为Ⅰ、Ⅱ级,无放化疗相关死亡病例。结论对初诊Ⅳ期NSCLC寡转移患者行胸部累及野精确放疗疗效优于单纯化疗,不良反应可耐受。
Objective To investigate the clinical effect of chest radiotherapy on stage Ⅳ non-small cell lung cancer (NSCLC) oligometastasis. Methods Totally 86 patients with newly diagnosed stage Ⅳ NSCLC oligodendroglioma who were confirmed by pathology and completed 4 cycles of platinum regimen chemotherapy were randomly divided into two groups: the chemotherapy group received observation or continued chemotherapy for 1 or 2 courses; radiotherapy Group accepted chest radiotherapy field radiotherapy precision, after observation or continue chemotherapy for 1 to 2 courses. To observe the clinical efficiency, disease control rate and 1, 2, 3-year survival rate, the occurrence of chest symptoms and radiotherapy and chemotherapy adverse reactions. Results The chemotherapy group and the radiotherapy group received continuous chemotherapy for 56 and 50 courses respectively. Radiotherapy efficiency, disease control rate and 1, 2, 3-year survival rates were higher than the chemotherapy group (P <0.05). Radiotherapy group sputum expectoration / wheezing, chest wall pain symptoms were lower than the chemotherapy group (P <0.05). Chemotherapy and chemotherapy adverse reactions are mostly Ⅰ, Ⅱ grade, no radiotherapy and chemotherapy-related deaths. Conclusions The accuracy of thoracic radiotherapy and radiotherapy for newly diagnosed stage IV NSCLC patients is better than that of chemotherapy alone. Adverse reactions can be tolerated.