累及野三维适形放射治疗老年人非小细胞肺癌的疗效分析  

Involved-field irradiation in three-dimensional conformal radiation therapy for elderly patients with advanced non-small cell lung cancer

作　　者：姚元虎[1] 章龙珍[1] 王侠[1] 唐天友[1] 王建设[1] 辛勇[1] 覃朝晖[2] 

机构地区：[1]徐州医学院附属医院放射治疗科 徐州医学院肿瘤放射治疗教研室,221002 [2]徐州医学院公共卫生学院

出　　处：《中华老年医学杂志》2009年第12期976-978,共3页Chinese Journal of Geriatrics

基　　金：徐州市科技发展基金（XM08C076）;徐州医学院院科研课题（08KJ22）

摘　　要：目的探讨累及野三维适形放射治疗老年非小细胞肺癌（NSCLC）的临床价值。方法48例老年NSCLC患者随机分为选择性淋巴引流区照射组（ENI）23例和累及野照射组（IFI）25例，患者年龄60-80岁，中位年龄70岁，均采用三维适形放射治疗技术。结果ENI组和IFI组的平均治疗剂量分别为（60．3±3．6）Gy和（66．4±4．7）Gy（t=5．06，P〈0．05），有效率分别为48．4％和79．0％（x^2=5．42，P=0．020），ENI组淋巴引流区内复发率为4．3%，IFI组为4．0％（x^2=0．04，P=0．950）。Kaplan—Meier分析结果显示，两组中位局部无进展时间分别为14．0个月和18．0个月，1年局部失败率分别为47．8％和32．0％（x^2=1．26，P=0．260）；总的中位生存期分别为16．0个月和18．0个月，2年生存率分别为8．7％和28．0％（x^2=2．93，P=0．087）。两组治疗相关并发症的发生率差异无统计学意义。结论对于不能手术的老年NSCLC患者，进行累及野三维适形放射治疗，可以提高疗效。Objective To evaluate the effect of involved field irradiation （IFI） in three- dimensional conformal radiation therapy （3D-CRT） for elderly patients with advanced non-small cell lung cancer （NSCLC）. Methods A total of 48 elderly patients with inoperable NSCLC were randomly divided into 2 groups. The 23 patients were as elective nodal irradiation （END group, and 25 patients were as IFI group. The patients aged 60 to 80 years, median age was 70 years old, and all underwent 3D-CRT. Results The mean prescription doses for gross tumor volume with ENI and IFI were （60. 3±3.6）Gy and （66.4±4.7）Gy（t=5.06,P=0.05）, the responsive rates were 48.4% and 79.0%（x^2=5. 42,P〈0. 020）, and the elective nodal failure rates were 4.3% and 4.0% （x^2= 0.04, P= 0. 950）, respectively. Kaplan Meier analysis showed that the median local progression-free survival time was 14 and 18 months, and 1-year local failure rates were 47.8% and 32.0%（x^2 = 1.26, P=0. 260） respectively. The overall median survival time was 16 and 18 months, and 2-year survival rates were 8.7% and 28.0% （x^2 = 2.93, P=0. 087）. There were no significant differences in occurrences of radiation-associated complications between two groups. Conclusions IFI in 3D-CRT improves the effect for the elderly patients with inoperable NSCLC.

关 键 词：放射疗法 计算机辅助 癌 非小细胞肺 治疗结果 

分 类 号：R686[医药卫生—骨科学]