体部伽玛刀治疗Ⅰ～Ⅱ期非小细胞肺癌的临床研究  

Clinical study of the Stage Ⅰ -Ⅱ Non-Small Cell Lung Cancer treated by gamma ray knife

作　　者：于湧[1] 夏廷毅[2] 周助明[1] 

机构地区：[1]贵州省贵阳市肺科医院,贵州贵阳550002 [2]空军总医院,北京100036

出　　处：《护士进修杂志》2005年第2期103-105,共3页Journal of Nurses Training

摘　　要：目的 观察评价体部伽玛刀治疗Ⅰ-Ⅱ期非小细胞肺癌(NSCLC)的近期疗效和放射反应。方法 对23例Ⅰ-Ⅱ期NSCLC采用旋转式体部伽玛刀治疗时用体架和真空负压袋固定体位,CT定位和三维计划,靶区在肺窗上勾画,与纵膈窗比较,PTV在GTV外扩1 cm,50％的剂量线覆盖95％以上的PTV范围,照射剂量为50％的剂量线5GY／次,每天1次,每周5次,共照射8-10次,总剂量为40-50GY,全部病例没有追加纵膈区的普通放疗,对有N1的病例只对肺门肿大淋巴结进行选择性照射,剂量同原发灶或小。结果 原发灶的完全缓解率(CR)65.1％(15／23),部分缓解率(PR)34.9％(8／23),总有效率为100%。肺的早期放射反应多数为0级;放射性肺炎Ⅰ级26.1％(6／23),Ⅱ级8.7％(2／23)。1、2年肿瘤局部控制率分别为92.3％(21／23)和85.7％(19／23)。结论 体部伽玛刀治疗早期NSCLC近期疗效好、放射反应轻,能为患者耐受,是一种安全的局部治疗手段。Objective To evalua the early effect and radiation response of gamma ray knife for the treatment of non-smallcelllungcancer. Method 23 patients with stage Ⅰ-Ⅱ Non-Small Cell Lung Cancer (NSCLC) were treated with the rotating type Gamma Ray Whole-Body Therapeutic System ( Body y-knife ) For body γ- knife treatment, a rotating type body frame for exact tumor localization, reproducible fixation. CT simulation and 3-D treatment plan has been developed. Body y-knife fraction schema-perphery dose 3-8 GY per day (50% dose line) . 5 day a weed was employed at a total dose of 40-50 GY. Results All patients treated with bodγ- knife were analyzed to evaluate the early response and acute complications. The complete response rate (CR) in the primary tumor was 65. 1% and the overall response rate (CR+PR) was 100%. After 2-3 month of radiotherapy. Acute radiation-induced pneumonitis was RTOG Grade Ⅰ21. 6%, Grade Ⅱ 8. 7%. The 1-2 year local control rates was 92. 9% and 85. 7%. Conclusion This new technology is noninvasive, painless, rapid,and dose not require hospitalization and impair the quality of life of the patients when used properly. Treatment has obtained a high response rate with minimal side effects. It's a safe way of Local treatment.

关 键 词：非小细胞肺癌/放射疗法 体部伽玛刀 临床研究 

分 类 号：R471[医药卫生—护理学] R615[医药卫生—临床医学]