非小细胞肺癌脑转移大剂量分割放疗的临床Ⅰ/Ⅱ期研究  

Hypofraction radiotherapy for patients with brain metastasis of non small cell lung cancer a Ⅰ/Ⅱ clinical phase

作　　者：杨焕军[1] 蒋国梁[1] 傅小龙[1] 钱浩[1] 王丽娟[1] 赵森[1] 

机构地区：[1]上海医科大学肿瘤医院放疗科,200032

出　　处：《上海医学》1999年第10期606-608,共3页Shanghai Medical Journal

摘　　要：目的　观察３ 种大剂量分割放疗对非小细胞肺癌（ Ｎ Ｓ Ｃ Ｌ Ｃ） 脑转移患者的耐受性及疗效。方法　１９９７ 年１ 月～１９９８ 年１２ 月共治疗 Ｎ Ｓ Ｃ Ｌ Ｃ 脑转移３５ 例，原发灶经病理证实，脑转移灶经 Ｃ Ｔ 和 Ｍ Ｒ Ｉ证实。根据 Ｎ Ｓ Ｃ Ｌ Ｃ 脑转移原发灶状态、转移情况制定３ 种大剂量分割放疗方案。结果　１ 例因癫癎发作终止治疗，３４ 例完成放疗计划。３ 组均无明显急性不良反应，疗效：除１ 例面麻症状改善不明显外，其余患者症状或体征放疗后均得到改善，３ 组无差异。第一组中位生存期２１ 周（２ ．５～７４ 周） ，第二组为２６ ．４ 周（９ ．４ ～９６ 周） ，第三组为３７ ．７ 周（３ ～４３ 周） ，第一组与第三组差异有显著性（ Ｐ＜ ０ ．０５） 。结论　 Ｎ Ｓ Ｃ Ｌ Ｃ 脑转移患者能耐受３ 种大分割照射剂量，无明显急性反应，初步疗效显示对有较好预后因素的患者加大放疗剂量可提高中位生存期。Objective To observe the tolerability and effectiveness of hypofraction irradiation for patients with non small cell lung cancer(NSCLC). Methods 35 cases which confirmed by CT or MRI scan were treated with hypofraction irradiation. Three schedules for brain radiotherapy were carried out, the first was whole brain irradiation with dose of 29.5～30.5 Gy/10 fx 12～14 days for 13 patients with active extracranialfoci. The second was also whole brain irradiation with dosagce of 38.4～39.5 Gy/13 fx for 17～19 days for 16 patients without active extracranial tumors but more than one lesion in the brain. And the third was whole brain irradiation with dosagce of 29.5～30.5 Gy/10 fx for 12～14 days then boosted to 44.9～45.2 Gy/15 fx, for 19～23 days in 6 patients with no active extracranial tumors but only one lesion.Results 34 cases with brain metastasis of NSCLC enrolled in this study(one patient was withdrawn due to seizure). All patients had no marked side effect. Symptoms and signs were improved after irradiation. The median survival period was much prolonged in the first and the second groups( P <0.05).Conclusion The schedules for brain radiotherapy could be tolerated for patients with brain metastasis of NSCLC. These data suggest that the survival period can be improved by given higher dosages for patients without active extracranial tumors.(Shanghai Med J, 1999,22∶606 608)

关 键 词：非小细胞肺癌 脑转移 放射疗法 大剂量 

分 类 号：R734.205[医药卫生—肿瘤] R73－37[医药卫生—临床医学]