高剂量率腔内治疗与单纯外照射治疗癌性肺不张的疗效比较  

Comparison of the therapeutic effects of HDR endobronchial brachytherapy and simple external irradiation on the treatment of lung cancer with atelectasis

作　　者：李德志[1] 李启明[1] 张青[1] 付尚志[1] 

机构地区：[1]第三军医大学附属新桥医院全军肿瘤治疗中心,重庆400037

出　　处：《第三军医大学学报》2003年第10期907-909,共3页Journal of Third Military Medical University

摘　　要：目的　探讨高剂量率腔内近距离放射治疗原发性肺癌伴癌性肺不张 (简称癌性肺不张 )的临床应用价值。方法 1991年 3月至 1996年 10月随机分组对照研究了 14 2例癌性肺不张支气管腔内治疗的疗效。与 7l例单纯外照射相对照 .治疗组在纤维支气管镜引导下经腔内近距离照射 2～ 3次 ,每次 8Gy ,间隔 5～ 7d .参考点距离 1～ 1.5cm。对照组用直线加速器常规外照射 60～ 70Gy ,照射范围参考纤维支气管镜检查病灶点为中心在模拟定位机下设定。结果　治疗后癌性肺不张复张率在治疗组为 80 .2 8%.对照组复张率为 64 .79%。两组间差异显著。治疗组中肺复张者l、2、3年生存率分别为 60 .68%、44 .44 %和 2 3 .93 %;肺未复张者分别为 3 6%、2 8%和 16%.两者比较 1年生存率差异显著 (P <0 .0 1)。结论　高剂量率支气管腔内近距离放射治疗癌性肺不张复张率显著高于常规外照射 (P <0 .0 1) .可提高 1年生存率 ,有较好的临床应用价值。对 2年和Objective Objective To investigate the clinical application of high-dose-rate(HDR)endobronchial brachytherapy for the treatment of primary lung cancer with atelectasis. Methods A total of 142 cases of lung cancer with atelectasis treated with HDR endobronchial brachytherapy and 71 cases(contr01)treated with extemal irradiation only at onr center of cancer were comparatively studied.1n the treatment group,with the aid of bmnchoscope,brachytherapy was applied 2 or 3 times at the dose of 8 Gy each time to a tissue depth of 1 to 1.5 cm.Cases in the contmlgroup,treated with external irradiation,received 60-70 Gy in total.Results Complete recruitment of atelectasis was observed in 80.28%cases of the treatment group and 64.79%in the control,T11ere Was significant difference between the two groups.Survival rates after 1,2 and 3 years in cases with complete remission of atelectasis in treatment group were 60.68%,44.44%and 23.93%,but 36.00%,28.00%and 16.00%in cases with no remission of atelectasis.Significant difference of one-year survival Was found between the two groups(P<0.01). Conclusion The recruitment rate of lung cancer with atelectasis treated with endobmnchial brachytherapy is higher than that with external irradiation(P<0.01)and higher survival rate Can be reached in treatment group(P<0.01).Endobronchial braehytherapy for lung cancer with atelectasis is of important clinical value.

关 键 词：肺癌 癌性肺不张 放射治疗 近距离治疗 

分 类 号：R563.405[医药卫生—呼吸系统] R734.206[医药卫生—内科学]