三维适形放射治疗非小细胞肺癌脑转移100例临床观察  

CLINICAL STUDY OF 100 PATIENTS WITH BRAIN METASTASES OF NON-SMALL CELL LUNG CANCER TREATED WITH THREE DIMENSIONAL CONFORMAL RADIOTHERAPY

作　　者：张辛[1] 王军[1] 李瑞东[2] 

机构地区：[1]河北医科大学第四医院放疗科,河北石家庄050011 [2]邢台医学高等专科学校附属医院肿瘤治疗中心,河北邢台054000

出　　处：《河北医科大学学报》2009年第9期928-931,共4页Journal of Hebei Medical University

摘　　要：目的探讨三维适形放疗非小细胞肺癌脑转移的剂量疗效及预后因素。方法三维立体适形放疗非小细胞肺癌脑转移患者100例,其中全脑放疗38例(3000～4000cGy)、全脑+局部加量62例(6000cGy);同期配合化疗44例。结果即期疗效达到完全缓解6例,部分缓解73例,无变化1 4例,进展7例;生存时间1～31个月,中位生存时间11个月;即期疗效以全脑+局部放疗方式为好,预后因素中有意义的指标是,是否有其他脏器转移及是否局部加量。主要不良反应为以脑水肿导致颅压高。结论三维立体适形放疗是非小细胞肺癌脑转移的有效治疗手段,不良反应较轻,耐受性好,能够在局部加量而不加重不良反应,能够提高患者生存质量。Objective To evaluate and analyze the dose-effect and prognostic factors of brain metastases of non-small cell lung cancer(NSCLC) treated with three dimensional conformal radiotherapy(3D-CRT).Methods One hundred patients with brain metastases of NSCLC treated with 3D-CRT were analyzed and evaluated retrospectively.Thirty-eight patients were treated with whole brain radiotherapy (WBRT) with prescription dose from 3 000 to 4 000 cGy,and 62 patients with local boosted to 6 000 cGy followed.Forty-four patients were treated with concurrent chemoradiotherapy.Results Six patients received complete response and 73 patients received partial response,14 patients no change and 7 patients progressive disease; The range of survival time of all the patients enrolled in this research was 1～31 months and the median survival time was 11 months.Local boosted dose followed whole brain radiotherapy showed better effect.No other organ metastasis and local boosted dose were favorable factors for survival in univariate and multivariate analysis.Hypertension in encephalon due to hydrocephalus was the main side-effect.Conclusion 3D-CRT was a effective treatment for patients with brain metastases of NSCLC as it takes slight side-effect and can be fairly well tolerated.Local boosted dose followed whole brain radiotherapy can promote the dose for tumor and improve the quality of life without aggravating the side-effect.

关 键 词：放射疗法 适形 癌 非小细胞肺 治疗 

分 类 号：R734.2[医药卫生—肿瘤]