91例非小细胞肺癌三维适形放疗的临床分析  

Preliminary results of three-dimensional conformal radiotherapy for non-small cell lung cancer

作　　者：王颖杰[1] 王绿化[1] 王鑫[1] 冯勤付[1] 张红星[1] 肖泽芬[1] 殷蔚伯[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放疗科

出　　处：《中华放射肿瘤学杂志》2005年第4期241-244,共4页Chinese Journal of Radiation Oncology

基　　金：首都医学发展科研基金(20021016)

摘　　要：目的分析三维适形放疗(3DCRT)在非小细胞肺癌(NSCLC)治疗中的效果和放射损伤情况,并分析其预后因素。方法接受3DCRT的91例NSCLC中男73例,女18例,中位年龄66岁。放疗中位单次剂量2Gy,5次/周,中位总剂量60Gy,中位随访期17个月。结果完全缓解11.0%(10/91),部分缓解46.2%(42/91),稳定33.0%(30/91),进展1.1%(1/91),有效率57.1%(52/91)。1、2年总生存率分别为67.0%、32.6%,中位生存期16个月。1、2年的无局部进展生存率分别为82.6%、53.0%。单因素和多因素分析都显示,体重下降≥5%预后不良。急性放射性肺炎2级2例,3级4例;晚期放射性肺炎2级1例,3级1例。急性放射性食管炎2级8例。急性2级骨髓毒性5例。结论3DCRT治疗NSCLC有很好的近期疗效,放射损伤在可接受范围。放疗总剂量还有提升的空间。Objective To evaluate the therapeutic effects and complications of three-dimensional conformal radiotherapy (3DCRT) for non-small cell lung cancer (NSCLC).Methods Between March 1999 and September 2003,91 NSCLC patients treated with 3DCRT were reviewed at the Cancer Hospital, Chinese Academy of Medical Sciences. This patient cohort consisted of 73 men and 18 women. The median age was 66 years. Radiotherapy was delivered at 2?Gy fraction, 5 fractions per week. The median total dose was 60?Gy. Results With a median follow-up time of 17 months, the response rate after 3DCRT was 57.1%, with complete remission 11.0%(10/91) and partial remission 46.2%(42/91). The median survival time (MST) was 16 months, with 1-and 2-year overall survivals (OS) of 67.0% and 32.6%, 1-and 2-year local progression free survivals (LPFS) of 82.6% and 53.0%, respectively. The independent adverse prognostic factors by univariate analysis and multivariate analysis was weight loss ≥ 5%.Grade 2 acute radiation pneumonitis was observed in 2 patients and grade 3 in 4 patients . Late lung injury developed in 1 patient with grade 2, 1 patient with grade 3, respectively. Acute radiation esophagitis was observed in 8 patients with grade 2. Acute grade 2 hematologic toxicity developed in 5 patients . Conclusions 3DCRT was feasible in the treatment of NSCLC with good immediate tumor response and acceptable normal tissue complication. The total dose may potentially be increased.

关 键 词：非小细胞肺癌 三维适形放疗 3DCRT NSCLC 放射损伤 肿瘤 放射疗法 呼吸系统 

分 类 号：R734.2[医药卫生—肿瘤]