常规加三维适形放射治疗老年人非小细胞肺癌临床分析  

Conventional radiotherapy combined with three-dimmentional conformal radiotherapy for treatment of non-small-cell lung cancer in the elderly

作　　者：汤华[1] 王建华[1] 陆忠华[1] 许锡元[1] 

机构地区：[1]江苏省常州市肿瘤医院肿瘤内科,213000

出　　处：《蚌埠医学院学报》2005年第6期509-511,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨提高放射治疗老年非小细胞肺癌(nonsmallcelllungcancer,NSCLC)疗效的方法。方法:对1998年11月～2000年12月83例60岁以上老年NSCLC患者按信封法随机分为治疗组(常规加三维适形放疗)和对照组(常规放疗)。两组常规放疗方法相同,先设前后对穿野,20次(5次/周)共照射DT40Gy,,治疗组用三维适形放疗每次补充DT3Gy,5次/周,共DT24Gy,对照组仍用常规放疗避开脊髓共补充DT20Gy,5次/周,2周。结果:治疗组3年生存率为36.6%,优于对照组的14.3%(P<0.05),治疗组无Ⅲ、Ⅳ级急性放射性食管炎,急性放射性肺炎和晚期放射性肺纤维化发生率为7.3%和39%。结论:常规加三维适形放射治疗可提高老年人NSCLC患者的3年生存率,同时降低急性及晚期放射反应。Objective： To evaluate the effect of radiotherapy on non-small-ceU lung cancer（NSCLC） in the elderly. Methods-From Nov. 1998 to Dec. 2000,83 patients over sixty were randomized into conventional radiotherapy plus three-dimmentional conformal radiotherapy（3DCRT） group and conventional radiotherapy（CT） group. The two groups were initially treated by the same conventional radiotherapy at a dose of 40 Gy, 20 fractions for four weeks. The patients in 3DCRT group were then administered 3DCRT in 3.0 Gy/f,5 fractions a week at a dose of 24 Cry. The patients in CT group received the same CT at a dose of 20 Gy,10 fractions for two weeks. Results： The 3-year survival rates were 36.6% in the 3DCRT group and 14.3% in the CT group. The difference of the two groups was significant（P〈0.05）. There was no grade Ⅲ or Ⅳ radiation esophagitis in the 3DCRT group. The incidences of acute radiation pneumonitis and radiation pulmonary fibrosis was 7.3% and 39% respectively in the 3DCRT group. Conclusions： In treatment of NSCLC in the elderly, conventional radiotherapy followed by 3DCRT may increase the 3-year survival rate and decrease the acute and late radiation reaction.

关 键 词：肺肿瘤 癌 非小细胞肺 放射疗法 老年病学 

分 类 号：R734.2[医药卫生—肿瘤]