摘要目的 分析早期非小细胞肺癌( NSCLC)放射治疗的疗效及预后影响因素.方法 收集不能或不愿手术的早期NSCLC患者81例.其中鳞状细胞癌60例,腺癌16例,腺鳞癌及未分型癌5例.常规放疗45例,三维适形放疗36例；剂量为50 ～ 96 Gy.Kaplan-Meier法和Log-rank法比较生存率,Cox回归分析法进行多因素分析.结果 全组中位生存时间34个月,总1、3、5年生存率分别为88.7％、41.9％、21.8％.单因素分析显示:不同Karnofsky评分(x2=19.56,P=0.000)、临床分期(x2=8.83,P=0.003)、肿瘤直径(x2=8.13,P=0.004)、近期疗效(x2=14.87,P=0.000)对生存影响差异有统计学意义.多因素回归分析显示放射治疗前Karnofsky评分(x2=11.27,P=0.001)和肿瘤直径(x2=4.89,P=0.027)是影响早期NSCLC患者预后的独立因素.结论 放射治疗前Karnofsky评分、肿瘤直径对早期NSCLC患者放射治疗的预后可能产生明显影响.

abstractsObjective To evaluate the prognosis influencing factors of early non-small cell luny cancer (NSCLC) after radiotherapy.Methods 81 early NSCLC patients received definitive radiotherapy and were eligible.Among these patients,60 were diagnosed as squamous cell carcinoma,16 were adenocarcinoma and 5 were diagnosed through imaging instead of pathology.45 patients received conventional radiotherapy,36 patients received three dimensional conformal radiotherapy (3D-CRT),All of them received a total dose of 50-96 Gy with a median dose of 67.8 Gy. Kaplan-Meier survival curves and Cox regression model analysis were applied to evaluate the survival and prognostic factors. Results The median survival time was 34 months.The 1-,3- and 5-year survival rates (OS) were 88.7 ％,41.9 ％,21.8 ％,respectively.Karnofsky performance status≥80,Clinical stage, diameter≤4 cm and the therapeutic effect were associated with improving overall survival.Cox hazards model showed that Karnofsky performance status≥ 80 and diameter≤4 cm were likely to be independent positive prognostic factors. Conclusion Karnofsky performance status and tumor diamater can be used to evaluate the prognosis of early NSCLC after radiotherapy.