不同剂量脑预防照射对局限期小细胞肺癌患者的临床观察  

Clinical observation of different doses of brain prophylactic irradiation for limited stage small cell lung cancer

作　　者：郑晓丽[1] 杨成梁[2,3] 葛红[2,3] 

机构地区：[1]郑州大学基础医学院,河南郑州450001 [2]河南省肿瘤医院 [3]郑州大学附属肿瘤医院放疗科,河南郑州450003

出　　处：《实用临床医药杂志》2012年第17期40-42,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11220116)

摘　　要：目的观察局限期小细胞肺癌不同剂量预防性全脑照射(PCI)对降低脑转移和生存率的影响。方法将本院收治的84例局限期小细胞肺癌患者随机分组,根据患者治疗要求分为标准PCI剂量组、较高PCI剂量组和对照组。观察患者两年脑转移发生率、总生存率以及放射性脑损伤引发的不良反应。结果标准剂量PCI组与较高剂量PCI组的2年脑转移发生率经比较,差异无统计学差异。发生脑转移患者与未发生脑转移患者的中位生存时间分别为17.6个月和47.4个月;标准剂量组的1年和3年生存率高于较高剂量组,但差异不明显。结论局限期小细胞肺癌术后化疗或放化疗后预防性脑照射可以降低脑转移率,25 Gy的PCI仍然应该是局限期小细胞肺癌的标准治疗剂量。Objective To observe the impact of different doses of prophylactic cranial irra- diation （PCI） to brain metastasis and survival rate for limited stage small cell lung cancer （LSS- CLC）. Methods Eighty-four LSSCLC patients admitted to our hospital were randomized into stan- dard-dose PCI group, higher-dose PCI group and control group. The incidence of brain metastasis, overall survival rate, as well as the adverse reactions caused by irradiative brain injury over a two- year period were observed. Results The incidence rates of two-year brain metastases in the standard -dose PCI group and the higher-dose PCI group showed no statistically significant difference. The median survival period of brain metastases patients and brain metastases patients was 17.6 months and 47.4 months, respectively. One-year and three-year survival rates of the standard-dose group were higher than the higher-dose group, but the difference was not significant. Conclusion After LSSCLC surgery and chemotherapy or radiotherapy and chemotherapy, prophylactic cranial irradia- tion can reduce the incidence rate of brain metastases. 25 Gy of PCI should remain the standard treatment dose for LSSCLS.

关 键 词：小细胞肺癌 局限期 预防性全脑照射 脑转移 生存率 

分 类 号：R734.2[医药卫生—肿瘤]