早期非小细胞肺癌三维适形放疗剂量分割研究  

Study on fractionation for early non-small cell lung cancer

作　　者：于金明[1] 任瑞美[2] 袁明智[1] 尹勇[1] 岳金波[1] 

机构地区：[1]山东省肿瘤医院放疗科,济南250117 [2]山东省肿瘤医院特需科,济南250117

出　　处：《中华放射肿瘤学杂志》2005年第3期158-161,共4页Chinese Journal of Radiation Oncology

摘　　要：目的　比较三维适形大分割加速放疗与常规分割放疗早期非小细胞肺癌的疗效。方法　6 0例Ⅰ、Ⅱ期非小细胞肺癌(NSCLC)患者随机均分为两组,一组行大分割加速放疗,4Gy/次,5次/周,总剂量4 8Gy ,2～3周完成;另一组行常规分割放疗,2Gy/次,5次/周,总剂量6 6Gy,6～7周完成。其中Ⅰ期患者行单纯放疗,Ⅱ期患者行放化疗,化疗采用NP方案,共4个疗程。结果　大分割加速放疗组1、2、3年总生存率和无病生存率分别为80 %和6 5 %、6 0 %和5 0 %、4 3%和33% ,常规分割放疗组分别为6 0 %和4 5 %、33%和2 3%、2 3%和10 % ;远地转移率分别为13%、37% ;局部复发率分别为2 3%、5 0 % ;放射性肺炎和放射性食管炎及骨髓抑制发生率相当,分别为5 0 %和5 3%及5 7%、4 0 %和5 0 %及4 7%。结论　三维适形大分割加速放疗早期NSCLC的效果优于常规分割放疗,毒副反应可以耐受。Objective To compare the effect of conventional fractionatio n and ac celerated hypofractionation in three-dimensional conformal radiotherapy for ear l y non-small cell lung cancer (NSCLC). Methods From July 1998 to July 2000, 60 patients with stage ⅠandⅡNSCLC were randomized into two groups : Accelerated hypofractionation group (AHF) by 48?Gy/12f/2-3w, and conventional group (CF) by 66?Gy/33f/6-7 w. Elective nodal irradiation was not performed in either group . StageⅠ patients received radiotherapy only, while stage Ⅱpatients received rad iotherapy plus 4 cycles of chemotherapy with vinorelbine and cisplatin (NP). Results The overall 1-, 2- and 3-years survival rates and disease-free survi val rates of the AHF were 80%, 60%, 43% and 65%, 50%, 33%, while those of CF group w ere 60%, 33%, 23% and 45%, 23%, 10%. The distant metastasis rate of AHF and CF g roups were 13% and 37%, and local recurrence rates were 23% and 50%. The inciden ce of radiation pneumonitis, esophagitis and bone marrow suppression were sim ila r. Conclusions The median survival time is significantly prolonged and the sur vival rate is improved by the accelerated hypofractionation in three-dimensiona l conformal radiotherapy for early NSCLC. The side-effects of accelerated hypof ractionation regimen are tolerable.

关 键 词：早期非小细胞肺癌 三维适形放疗 非小细胞肺癌(NSCLC) 剂量分割 常规分割放疗 加速放疗 放射性食管炎 无病生存率 远地转移率 局部复发率 放射性肺炎 大分割 单纯放疗 NP方案 总生存率 骨髓抑制 毒副反应 患者 放化疗 发生率 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]