三维适形放疗局限期小细胞肺癌临床报道  

CLINICAL RESULTS OF THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY FOR LIMITED SMALL CELL LUNG CANCER

作　　者：杨俊泉[1] 王翠兰[1] 张月恒[1] 王洪娟[1] 张瑞娟[1] 熊伟[1] 

机构地区：[1]唐山市人民医院放化疗科,唐山063000

出　　处：《现代预防医学》2006年第6期1029-1031,共3页Modern Preventive Medicine

摘　　要：目的：评价三维适形放射治疗（3D-CRT）在局限期小细胞肺癌（LSCLC）治疗中的疗效和毒副反应。方法：65例LSCLC患者。一组采用化疗序贯（3D-CRT）31例综合治疗，放疗靶区只包括CT可见的原发和淋巴结转移病变。单次剂量为3-4GY，每周5次，12～15次，中位生物学效应剂量为60GY。另一组采用化疗序贯普通外照射放疗34例，放疗靶区包括原发灶、同侧肺门、全纵隔和双侧锁骨上淋巴引流区，常规放疗200CGY／F，5F／W，DT50-60GY。两组病例放疗旨在化疗两周期后进行，化疗方案为EP或CE方案，4～6个周期。结果：3D-CRT组有效率为79．41％，其中完全缓解率32．35％，部分缓解率47．06％；普通放疗组有效率为54.84％，其中完全缓解率22．58％，部分缓解率32．26％。1、2年总生存率3D-CRT组70．59％、38．24％；普通放疗组61．29％、32．26％。中位生存时间3D-CRT组为19个月，普通放疗组为15个月。1、2年无局部进展生存率3D-CRT组为90.59％、58.83％；普通放疗组83.88％、52.26％。1、2级急性放射性肺炎3D-CRT组8．82％；普通放疗组为22．58％。1、2级晚期放射性肺损伤3D-CRT组为12．90％；普通放疗组为25．80％。1、2级急性放射性食管炎3D-CRT组为12．90％；普通放疗组为29．03％，3D-CRT组无3级以上放射性肺和食管损伤发生：普通放疗组3级放射性肺炎为12．90％，3级放射性食管炎为16．13％。结论：3D-CRT治疗KCLC疗效好，副反应轻，值得进一步研究。Objective： To compare the therapeutic effects and side effect of three - dimensional conformal radiotherapy （3D - CRT） versus conventional radiotherapy （CR） for limited small cell lung cancer.Methotls： From May 2000 to October 2003, 65 patients with limited small cell lung cancer were treated. Group A： 31 patients received 3D - CRT, 3 - 4GY/F, 5F/W, median BED= 60GY. The radiation fields covered only primary tumor and lymphadeopathy detected by CT; Group B： 34 patients received conventional radiotherapy, 200CGY/F, 5F/W, DTS0-60GY/5- 6W. The radiation fields covered primary tumor, draining hilar lymphatics, mediastinum and bilateral supraelavicular areas . Radiation was started after two eyries of chemotherapy in two Results： （1） The overall response rate was 79.41% in 3D-CRT group with a complete remission rate of 32.35 %, and that was 54.84 % in CR group with a complete remission rate of 22.58%. 1 -, 2 - year survival rate was 70.59% , 61.29 % of 3D -CRT group and38.24 %, 32.26% of CR group respectively.Median survival time was 19months and 15 months in 3D- CRT group and CP. group respectively. The number of patients with grade 3 acute radiation pneumontis and esophagitis developed in the 3D- CRT group is lower than that in the conventional radiation group.Conclusion： Three-dimensional conformal radiotherapy （3D -CRT） is a better treatment for LSCLC with higher response rate and less complications than conventional radiotherapy

关 键 词：三维适形放射治疗 小细胞肺癌 放射损伤 

分 类 号：R734.2[医药卫生—肿瘤]