36例老年非小细胞肺癌患者三维适形放疗的疗效观察  

Observation on three-dimensional conformal radiotherapy (3D-CRT) for 36 elderly patients with non-small cell lung cancer

作　　者：石卫民[1] 侯友贤[1] 黎静[1] 李志强[1] 陈海[1] 

机构地区：[1]广州军区广州总医院放射肿瘤中心,广州510010

出　　处：《解放军医学杂志》2007年第7期667-668,共2页Medical Journal of Chinese People's Liberation Army

基　　金：广东省医学科研基金立项课题(A2002535)

摘　　要：目的观察三维放射治疗(3D-CRT)治疗老年非小细胞肺癌患者的疗效和副反应。方法2001年8月～2006年10月,应用3D-CRT技术治疗70岁以上非小细胞肺癌患者36例。以Leibinger三维放疗计划系统制订放疗计划,处方剂量为40～80Gy(中位剂量60Gy)。其中采用低分割照射者24例,单次分割剂量5～8Gy,隔日照射,共8～12次照射;常规分割者12例,共30～40次照射。观察所有患者的肿瘤反应率,1、2年的生存率及治疗毒副作用。结果33例患者治疗后临床症状获得改善,3例无变化。肿瘤获得完全缓解8例,部分缓解22例,肿瘤总反应率83·33%(30/36)。全组生存时间为2～53个月,中位生存时间8个月,1年生存率66·67%,2年生存率36·11%。无严重并发症。结论对于老年非小细胞肺癌患者,3D-CRT技术是一种安全有效的治疗手段,能够改善生存质量,提高生存率。Objective To evaluate the therapeutic effects and adverse effects of three-dimensional conformal radiotherapy （3D-CRT） for elderly patients with non-small cell lung cancer （NSCLC）. Methods From August 2001 to October 2006, 36 patients over 70 years old with NSCLC were treated with 3D-CRT. Leibirtger treatment planning system was used for drafting radiotherapy plan, the prescription dose was 40-80Gy （median, 60Gy）. Twenty-four patients received hypofractionated radiation every two days in 8-12 fractions at a dose of 5-8Gy per fraction; 12 patients accepted conventional fractionated radiation with 30-40 fractions during 6 to 7 weeks. With median follow-up time of 11 months （range, 5-54 mon. ）, tumor volume response rate, 1-year and 2-year survival rate were investigated, adverse effects of the treatment were also recorded in present research. Results Of the 36 patients, clinical symptoms were improved in 33 cases, while no changes were observed in 3 cases. According to follow-up CT results 2-3 months after radiotherapy, 8 patients showed complete response （CR）, 22 cases with partial response （PR）, with the overall tumor response rate of 83. 33% （30/36）. In this group, 1-year and 2-year survival rate was 66. 67% and 36. 11% with median survival time of 8 months （range, 2-53 months）. No patients suffered from serious adverse effects. Conclusions 3D-CRT was an effective and safe treatment for elderly patients with NSCLC, which could raise the survival rate and improve the quality of life with little adverse effects.

关 键 词：癌 非小细胞肺 放射疗法 适形 老年人 

分 类 号：R734.205[医药卫生—肿瘤]