小细胞肺癌的三维适形放射治疗  

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

作　　者：王颖杰[1] 王绿化[1] 陈东福[1] 周宗玫[1] 欧广飞[1] 梁军[1] 张可[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射治疗科

出　　处：《中华肿瘤杂志》2005年第9期570-572,共3页Chinese Journal of Oncology

基　　金：首都医学发展科研基金(2002-1016)

摘　　要：目的分析三维适形放射治疗(3DCRT)在小细胞肺癌(SCLC)治疗中的可行性、效果和放射损伤情况.方法 19例SCLC患者中,局限期18例,广泛期1例.18例采用放化疗综合治疗,1例采用单独放疗.放疗单次剂量2 Gy,每周5次,中位总剂量54 Gy.化疗多采用卡铂或顺铂+VP-16为主的方案,4～6个周期.中位随访24个月.结果 (1)全组患者 CR率为 31.6%(6/19),PR率为47.4%(9/19),SD率为21.1%(4/19),有效率为79.0%.1年总生存率(OS)为71.7%,2年OS为35.8%,中位生存时间为19个月.1,2年无局部进展生存率均为94.7%.(2) 2级急性放射性肺损伤为5.3%(1/19),2级晚期放射性肺损伤为5.3%(1/19),2级急性放射性食管损伤10.5%(2/19),2级血液学毒性为10.5%(2/19).结论 3DCRT用于SCLC治疗是可行的,患者能够获得较好的近期疗效和2年生存率,SCLC的三维适形放射治疗值得进一步研究.Objective To evaluate the feasibility, therapeutic effects and complications of three- dimensional conformal radiotherapy （3DCRT）for small-cell lung cancer（SCLC）. Methods The data of 19 SCLC patients treated between June 2001 and August 2003, with 3DCRT were reviewed and analyzed. Eighteen patients were treated by radiotherapy plus chemotherapy while only 1 patient by radiotherapy alone. Radiotherapy was delivered at 2 Gy/fraction, 5 fractions per week with a median total dose of 54 Gy. Chemotherapy consisted of 4-6 cycles of etoposide and eisplatin or carboplatin. The median follow-up time was 24 months. Results （ 1 ） The overall response rate after 3DCRT was 79. 0% , with a complete remission rate of 31. 6% （6/19） , partial remission rate of 47. 4% （9/19）. The 1- and 2-year overall survival （OS） was 71.7% and 35.8% respectively, with a median survival time （MST） of 19 months, and both the 1- and 2-year local progression free survival （LPFS） were 94.7%. （2） Of these 19 patients, grade 2 acute radiation pneumonitis developed in 5.3% , grade 2 late radiadtion pneumofibrosis in 5.3% , grade 2 acute radiation esophagitis in 10.5% and grade 2 acute hematologic toxicity in 10.5%. Conclusion Three-dimensional conformal radiotherapy is feasible in the treatment of SCLC with high response rate and acceptable complications . Further observation , more patients treated by 3DCRT and prolonged follow-up are needed to evaluate remote survival.

关 键 词：三维适形放射治疗 小细胞肺癌/放射疗法 放射损伤 三维适形放射治疗(3DCRT) 小细胞肺癌(SCLC) 急性放射性肺损伤 放化疗综合治疗 LC患者 总生存率 单次剂量 

分 类 号：R734.2[医药卫生—肿瘤]