127例Ⅳ期非小细胞肺癌三维适形放疗疗效分析  

Effect of 127 patients with stage Ⅳ non-small cell lung cancer treated with three-dimensional conformal radiotherapy

作　　者：蔡园园[1] 尤庆山[2] 

机构地区：[1]潍坊市人民医院,山东潍坊261041 [2]哈尔滨医科大学附属第三医院,黑龙江哈尔滨150081

出　　处：《现代肿瘤医学》2015年第3期344-349,共6页Journal of Modern Oncology

摘　　要：目的:探讨三维适形放射治疗(3-dementional conformal radiiation therapy,3-DCRT)对Ⅳ期非小细胞肺癌的疗效及影响预后的因素。方法:对2004年12月-2007年12月由我院放疗科收治的经三维适形放疗的127例Ⅳ期非小细胞肺癌病人进行回顾性分析。其中单纯放疗35例,放疗加化疗92例。原发灶及区域淋巴结的中位照射剂量为64.6Gy,转移灶的中位照射剂量为53.2Gy。评价其疗效、毒副作用、中位生存时间、半年、1年、2年、3年生存率。运用SPSS 17.0统计软件分析Ⅳ期非小细胞肺癌生存的相关因素。结果:全组总半年、1年、2年、3年生存率分别为80%、49%、12%、7%,中位生存时间12个月,有效率82.7%。骨转移有效疼痛缓解率93.18%(CR 15例,PR 26例,NR 3例)。治疗中1例肝转移患者出现Ⅰ级放射性肝炎;1例脑转移患者在治疗之后一个月出现头痛、恶心、呕吐,2例骨转移患者出现III度骨髓抑制。无放射性肺炎发生。COX分析显示生存率与KPS、联合化疗、原发灶放疗、放疗剂量、病理类型、转移器官数目有关;而性别、年龄、伴有合并症及转移灶部位对生存期无明显影响。结论:3-DCRT可延长Ⅳ期非小细胞肺癌患者的生存期,提高生活质量。一般状况佳、原发灶控制、高剂量放疗、联合化疗、腺癌、转移器管数目少是Ⅳ期NSCLC长期生存的主要影响因素。Objective：To evaluate the effect and prognostic factors of patients with stage Ⅳ non - small cell lung cancer （NSCLC） treated with three dimensional conformal radiation therapy （3 - DCRT）. Methods：From 2004 to 2007,127 patients with stage Ⅳ NSCLC treated with 3 - DCRT, were restrospeetively analyed. 35 cases were treated with 3 - DCRT and 92 with 3 - DCRT combined with chemotherapy. The median dose of primary tumor and regional lymph nodes was 64.6Gy,the median dose of metastatic 53.2Gy. To evaluate the efficacy,toxicity and side effects ,the median survival time, half - year, 1 - year,2 - year, 3 - year survival rate, and analyze related factors affecting survival rate. Results：Half- year, 1 -year, 2 -year, 3 -year survival rates were 80%, 49%, 12%, 7%, the median survival time was 12 months. The effective rate was 82.7%. Pain relief in 93.18% bone metastasis （ CR 15 cases ,PR 26 ea- ses, NR 3 cases）. 1 case appear liver metastases. No radioactive pneumonia. COX analysis showed that the KPS, com- bined with chemotherapy, radiotherapy, radiotherapy dose of primary tumor, pathological type, number of organ metas- tasis associated with survival rate. And the gender, age,had no significant effect on survival. Conclusion：3 - DCRT can prolong the survival of patients with stage Ⅳ non -small cell lung cancer, improve the quality of life. The general condition is good, the primary control, high dose radiotherapy, chemotherapy, adenocarcinoma, small number of transfer pipe are the main factors affecting the long - term survival of stage Ⅳ NSCLC.

关 键 词：非小细胞肺癌 Ⅳ期 三维适形放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R734.2[医药卫生—临床医学]