72例非小细胞肺癌脑转移调强放射治疗疗效分析  

Outcomes of intensity modulated radiotherapy for 72 patients with brain metastases from non-small cell lung cancer

作　　者：林育毅[1] 陈万泉[1] 张纬建[2] 洪芙蓉[2] 卢开贤[2] 邹喜[2] 

机构地区：[1]厦门市第二医院,福建厦门361021 [2]福建医科大学第一临床学院,福建福州350004

出　　处：《临床医药实践》2015年第11期805-808,共4页Proceeding of Clinical Medicine

摘　　要：目的：探讨非小细胞肺癌（NSCLC）脑转移调强放射治疗的临床疗效和毒性反应。方法：72例 NSCLC 脑转移患者采用共面5野同步补量（SIB）调强放疗（IMRT）进行治疗，全脑放疗（WBRT）剂量，DT40 Gy，每次2 Gy，每周5次，共20次，脑转移灶（PTV - GTV）同步加量，DT 50-60 Gy，每次2.5-3.0 Gy，共20次。95%的等剂量曲线包括靶区。放疗结束后1个月行脑部增强 MRI 或 CT 评价疗效。结果：完全缓解（CR）6例（8.3%），部分缓解（PR）57例（79.2%），疾病稳定（SD）5例（6.9%），进展（PD）4例（5.6%）。治疗有效率87.5%（63/72）。全组中位生存期为13个月。1，2年生存率分别为54.2%和23.6%。主要毒副反应为恶心呕吐、脑水肿等。结论：IMRT 治疗 NSCLC 脑转移有较好的疗效，毒副反应可耐受。Objective：Through the observation outcomes with intensity - modulated radiotherapy to explore the efficacy and toxicities of intensity - modulated radiotherapy to treat the brain metastases of non - small cell lung cancer. Methods：A to-tal of 72 non - small cell lung cancer（NSCLC）patients were treated by intensity - modulated radiotherapy（IMRT）with five coplanar beams using simultaneous integrated boost（SIB）technique from May 2008 to November 2012. The prescription dose was 50-60 Gy（PTV - G：brain metastases）and 40 Gy by whole - brain irradiation therapy（WBRT）in 20 fractions. Response was evaluated by contrast - enhanced brain MRI or CT one month after the end of radiotherapy. The 95% equi - dosage line in-clude the target area. Results：The complete remission（CR）of imaging was 8. 3% ,partial remission（PR）was 79. 2% ,stable disease（SD）was 6. 9% and progressive disease（PD）was 5. 6% . The effective rate was was 87. 5%（63 / 72）. The overall median survival was 13 months. The 1 - year and 2 - years survival rate were 54. 2% and 23. 6% . The main toxicities were nausea and vomiting,brain edema. Conclusion：Intensity - modulated radiotherapy is highly effective and well tolerated in treat-ment of NSCLC with brain metastases. It may be worthy of further clinical investigation and application.

关 键 词：非小细胞肺癌 脑转移 放射治疗 全脑放疗 调强放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]