体部γ-刀高分次剂量治疗Ⅰ～Ⅱ期非小细胞肺癌的临床研究  

Clinical Study of Body Gamma Knife in the Treatment of Non-Small Cell Lung Cancer:Preliminary Results of A Pilot Study

作　　者：夏廷毅[1] 孙庆选[1] 李平[1] 于勇[1] 崔纪青[1] 范乃斌[1] 

机构地区：[1]解放军空军总医院肿瘤放疗科,北京100036

出　　处：《临床肿瘤学杂志》2005年第1期20-24,共5页Chinese Clinical Oncology

摘　　要：目的:评价体部γ- 刀高分次剂量治疗Ⅰ～Ⅱ期非小细胞肺癌的疗效和放射反应。方法:对28例Ⅰ～Ⅱ期非 小细胞肺癌采用国产旋转式体部γ -刀治疗,治疗时用真空负压袋固定体位、CT定位扫描和三维计划。照射剂量肿瘤边缘 (50%剂量线)5Gy/次,5次/周,肿瘤局部总剂量40～50Gy。结果:原发灶的完全缓解率(CR)67.9%(19/28),部分缓解率 (PR)32.1%(9/28),总有效率100%。28例全部按计划完成治疗,放射反应较轻,放射性肺炎,Ⅰ级占25%(7/28),Ⅱ级占 10.7%(3/28)。放射性食管反应在周围型肺癌几乎没有,中心型肺癌的7例中,Ⅰ级5例,Ⅱ级2例。1、2年肿瘤局部控制率 和总生存率分别为92.3%、82.8%和85.7%、76.5%。结论:体部伽玛刀治疗早期非小细胞肺癌近期疗效好,放射反应轻,能 为所有患者耐受,是一种有效安全的局部治疗手段之一;但是其远期疗效和晚发性放射损伤尚有待进一步观察。Objective:To evaluate the early response and acute radiation reaction of body γ-knife in the treatment of non-small cell lung cancer.Methods:28 patients with stage Ⅰ-Ⅱnon-small cell lung cancer(NSCLC) were treated with the Stereotactic Gamma Ray Whole-Body Therapeutic System(Body γ-knife,QGD;OUR International Technology & Science Co.,LTD,Shenzhen,China).For body γ-knife treatment, a stereotactic body frame for exact tumor localization,reproducible fixation,CT simulation and 3-D treatment plan has been developed.Body γ-knife fraction schema-periphery dose 3-8Gy per day (50% dose line),5 day a week-was employed,at a total dose of 40-50Gy.Results:All patients treated with body γ-knife were analyzed to evaluate the early responses and acute complications.The complete response rate(CR)in the primary tumor was 67.9%,and the overall response rate (CR+PR)was 100% after 2-3 months of radiotherapy.Acute radiation-induced esophagitis occurred in 25% of patients (Grades Ⅰ 17.9% (PTOG),Grade Ⅱ 7.1%).Acute radiation-induced pneumonitis was observed in 35.7% of patients (Grade Ⅰ 25% (RTOG),Grade Ⅱ 10.7%).The 1-year,2-year local control rates and 1-year,2-year survival rates were 92.3%,82.8% and 85.7% and 76.5%,respectively.Conclusion:This new technology,which is noninvasive,painless,and rapid and need not to hospitalization,does not impair the quality of life of the patients when used properly.Treatment has obtained a high response rate with minimal side effects.Remote results await further follow-up.

关 键 词：治疗 非小细胞肺癌 肿瘤 体部γ-刀 放射反应 剂量 临床研究 原发灶 中心型肺癌 总有效率 

分 类 号：R734[医药卫生—肿瘤] R735.7[医药卫生—临床医学]