三维适形放疗联合立体定向放疗加量对局部晚期周围型非小细胞肺癌的疗效观察  

Clinical Observation of Three Dimensional Conformal Radiation Therapy Followed by Stereotactic Body Radiation Therapy for Peripheral Local Advanced Non-small Cell Lung Cancer

作　　者：李爽[1] 罗海峰[1] 李晶晶[1] 杨继元[1] 

机构地区：[1]长江大学附属第一医院(荆州市第一人民医院),434000

出　　处：《实用癌症杂志》2016年第12期1996-1999,共4页The Practical Journal of Cancer

摘　　要：目的观察三维适形放射治疗(3DCRT)结合立体定向放射治疗(SBRT)方法推量的照射方法,对局部晚期周围型非小细胞肺癌的疗效。方法对47例局部进展期周围型非小细胞肺癌患者,采用CT模拟定位,TPS计划上勾画靶区,常规3~5野照射,PTV剂量达到46~60 Gy后,针对肺部病灶采用立体定向放射治疗方法加量5~6 Gy×3F^4F,肺部肿瘤等效生物剂量(BED)达到72~86 Gy。结果 47例患者全部完成治疗,仅1例出现Ⅲ度放射性肺炎,无严重晚期放射性肺炎发生。完全缓解率为78.7%(CR 37例),部分缓解率为14.9%(PR 7例),稳定率6.4%(NC 3例),总有效率(CR+PR)为93.6%。1年局控率为95.7%(45/47),2年局控率为80.9%(38/47)。1、2、3年总生存率分别为76.6%、51.1%、31.9%。结论局部晚期周围型非小细胞肺癌,采用3DCRT结合SBRT的放射治疗方式,发生严重放射性肺炎几率低,局控率好。Objective To study the efficacy of three dimensional conformal radiation therapy followed by stereotactic body radiation therapy for peripheral local advanced non-small cell lung cancer. Methods 47 cases of peripheral local advanced non-small cell lung cancer patients were treated by 3DCRT of 46-60 Gy,then the peripheral lung mass were given 5 Gy-6 Gy×3F-4F by SBRT. The Biological equivalent dose（BED） of the primary lung tumor were 72 Gy-86 Gy. Results All patients were followed up after treatment for 6-45 months, the mean follow-up time was 38 months, 1 case of grade 3 radiation pneumonitis was observed., complete remission（CR） rate was 78.7% （37/47）, partial remission（FR） rate was 14.9% （7/47）, the total effective rate（ CR ＋ PR） was 93.6%. 1-and 2-year local control rate were 95.7% （45/47） and 80.9% （38/47）, respectively. 1-,2-,3- year overall survival rate were 76.6% ,51.1% ,31.9% ,respectively. Conclusion For peripheral local advanced non-small cell lung cancer,the treatment of three dimensional conformal radiotherapy followed by stereotactic body radiation therapy has high tumor control rate,high survival rate and less toxicities.

关 键 词：非小细胞肺癌 三维适形放射治疗 立体定向放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]