非小细胞肺癌不同分割剂量三维适形放疗与常规放疗的比较  

Different fractionated three dimensional conformal radiotherapy versus conventional radiotherapy in non-small cell lung cancer

作　　者：牛道立[1] 胡惠玲[2] 何芬[1] 曲志峰[2] 

机构地区：[1]广州医学院第一附属医院放疗科,510120 [2]河南科技大学第一附属医院放疗科

出　　处：《中华生物医学工程杂志》2009年第3期194-198,共5页Chinese Journal of Biomedical Engineering

摘　　要：目的比较不同分割剂量三维适形放疗（3DCRT）和常规放疗（CRT）治疗非小细胞肺癌（NSCLC）的疗效及放疗不良反应。方法回顾性分析1997年6月至2002年6月收治的207例NSCLC病例资料，根据治疗方法分为3组：126例患者行3DCRT按分割剂量分为3DCRTⅠ组和3DCRTⅡ／组，其中3DCRTI组57例，每次照射5～6Gy，隔日照射1次，治疗进行8-10次，共18～22d，总剂量48—50Gy；3DCRTⅡ组69例，每次照射2Gy，每日照射1次，治疗进行33～35次，共45～49d，总剂量66-70Gy；81例采用CRT为CRT组，每次照射2Gy，每日照射1次，治疗进行33～35次，共45～49d，总剂量66～70Gy。比较3组的疗效及放疗不良反应。结果3DCRTⅠ组1、3、5年生存率分别为84．2％（48／57）、40．4％（23／57）和17．5％（10／57）；3DCRTⅡ组1、3、5年生存率分别为76．8％（53／69）、31．9％（22／69）和13．0％（9／69）；CRT组1年、3年、5年生存率分别为65．4％（53／81）、23．5％（19／81）和8．6％（7／81）。3组患者局部控制率及生存率曲线差异具有统计学意义（均P〈0．05）。放射损伤主要为放射性肺纤维化和放射性食管炎，CRT组发生率较高（P〈0．05）：结论3DCRT对NSCLC有较好的疗效，放疗损伤较CRT低，尤以3DCRTⅠ组疗效较好，更具优势。Objective To compare the effectiveness and side effects of different fractionated three dimensional conformal radiotherapy （3DCRT） and conventional radiotherapy （CRT）in patients with non- small cell lung cancer （NSCLC）. Methods From June 1997 to June 2002, 207 cases of NSCLC treated by 3DCRT or CRT were divided into three groups （3DCRT Ⅰ group, 3DCRT Ⅱ group and CRT group） in terms of different radiation therapy and fractioned dosage. 3DCRT Ⅰ group （57 patients） was irradiated with 5 to 6 Gy every other day （total 48 to 50 Gy） and there were 8 to 10 radiotherapies during 18 to 22 d. 3DCRT Ⅱ group （69 patients） had a single dose of 2 Gy and was irradiated every day （total 66 to 70 Gy）, and there were 33 to 35 radiotherapies during 45 to 49 d. CRT group （81 patients） was treated with a daily dosage of 2 Gy （total 66 to 70 Gy）, and there were 33 to 35 radiotherapies during 45 to 49 d. The effectiveness and side effects were compared in 3 groups. Results The survival rates of 1-, 3- and 5-year in 3DCRT I group were 84.2% （48/57）, 40.4% （23/57） and 17.5%（10/57） respectively; in 3DCRT Ⅱ group were 76.8% （53/69）, 31.9% （22/69） and 13.0% （9/69） respectively; and in CRT group were 65.4% （53/81） , 23.5% （19/81） and 8.6% （7/81） respectively. There was significant difference in improvement rate of local lesion and survival curve （all P〈0.05 ）. The side effects including radiation pulmonary fibrosis and radiation esophagitis appeared in all three groups. The rate of side effect was highest in CRT Group （P〈0.05）. Conclusion 3DCRT is an effective therapy for NSCLC, which possesses better efficacy and less side effect compared with other two methods.

关 键 词：癌 非小细胞肺 放射疗法 三维适形放射疗法 放射剂量分次 治疗效果 

分 类 号：R734.2[医药卫生—肿瘤]