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探讨单纯放射治疗对不能手术的肺上沟瘤的作用。方法:回顾性分析1983年1月～2002年12月在本院治疗的47例肺上沟瘤患者。Ⅱb期13例,Ⅲb期25例,Ⅳ期9例。全组患者均接受放射治疗,放疗剂量为DT14Gy～99Gy,中位剂量70Gy,其中8例<50Gy,39例≥50Gy。结果:放疗后26例(55.3%)肿瘤缩小。疼痛缓解率为81.8%,疼痛缓解中位时间为5个月(2～23个月)。全组患者的中位生存时间(MST)为8个月,1、2、3、5年总生存率分别为24.7%、7.7%、3.8%和0。Ⅱb期、Ⅲb期和Ⅳ期患者的MST分别为12个月、8个月和5个月(P=0.552)。38例临床Ⅱb和Ⅲb期患者,放疗后肿瘤无变化和肿瘤缩小者的中位生存时间为6个月和11个月(P=0.0003)。放疗后疼痛消失、缓解和无效患者的中位生存时间分别为16个月、9个月和7个月(P=0.016)。放疗剂量<50Gy和≥50Gy患者的中位生存时间分别为3个月和9个月(P=0.0085)。结论:对不能手术的肺上沟瘤患者,放疗能缓解疼痛。放疗剂量≥50Gy、局部肿瘤缩小和疼痛缓解患者的总生存率有显著提高。
To investigate the role of radiotherapy alone in the treatment of inoperable lung tumor. Methods: A retrospective analysis of January 1983 ~ December 2002 in our hospital for treatment of 47 patients with pulmonary supraspinatus. 13 cases were stage IIb, 25 cases were stage IIIb and 9 cases were stage IV. All patients received radiation therapy, radiation dose of DT14Gy ~ 99Gy, the median dose of 70Gy, of which 8 cases <50Gy, 39 cases ≥ 50Gy. Results: Twenty-six patients (55.3%) had tumors shrinking after radiotherapy. The pain relief rate was 81.8% and the pain relief median time was 5 months (2-23 months). The overall median survival time (MST) for all patients was 8 months. The overall survival at 1, 2, 3, and 5 years was 24.7%, 7.7%, 3.8%, and 0, respectively. Patients with stage IIb, stage IIIb, and stage IV had a MST of 12 months, 8 months, and 5 months, respectively (P = 0.552). Thirty-eight patients with stage IIb and IIIb had a median survival of 6 months and 11 months after radiotherapy with no change in tumor size and tumor size (P = 0.0003). The pain disappeared after radiotherapy, and the median survival time was 16 months, 9 months and 7 months in patients with remission and ineffectiveness, respectively (P = 0.016). The median survival time for radiotherapy doses <50 Gy and ≥50 Gy were 3 months and 9 months, respectively (P = 0.0085). Conclusion: Radiotherapy can relieve pain in patients with lung pituitary tumor who can not be operated. Radiotherapy dose ≥ 50Gy, local tumor shrinkage and pain relief in patients with a significant increase in overall survival.