胸部精确放疗在Ⅳ期非小细胞肺癌寡转移患者的临床疗效  

Clinical value of thoracic precise radiotherapy in stage Ⅳ non-small cell lung cancer patients with pulmonary oligo metastasis

作　　者：沈斌[1] 张海兵[1] 陈永朝[1] 马振超[1] 俞根华[1] 

机构地区：[1]湖州市中心医院(浙江大学湖州医院)放疗科,浙江省313000

出　　处：《江苏医药》2017年第11期777-780,共4页Jiangsu Medical Journal

基　　金：浙江省公益性技术应用研究项目(2011C33051);湖州市科技计划项目(2013GYB03)

摘　　要：目的探讨胸部精确放疗对Ⅳ期非小细胞肺癌(NSCLC)寡转移患者的临床疗效。方法经病理确诊并完成4个周期含铂方案化疗后达疾病控制的初诊Ⅳ期NSCLC寡转移患者86例,随机均分为两组:化疗组接受观察或继续化疗1~2个疗程;放化组接受胸部累及野照射精确放疗,后观察或继续化疗1~2个疗程。观察临床有效率、疾病控制率及1、2、3年生存率、胸部症状发生情况及放化疗不良反应。结果化疗组和放化组分别接受继续化疗共56和50个疗程。放化组有效率、疾病控制率及1、2、3年生存率均高于化疗组(P<0.05)。放化组咳痰/喘鸣、胸壁疼痛症状低于化疗组(P<0.05)。放化疗不良反应多为Ⅰ、Ⅱ级,无放化疗相关死亡病例。结论对初诊Ⅳ期NSCLC寡转移患者行胸部累及野精确放疗疗效优于单纯化疗,不良反应可耐受。Objective To investigate clinical value of thoracic precise radiotherapy in the patients with stage Ⅳ non-small cell lung cancer（NSCLC）and pulmonary oligo metastasis.Methods Eighty-six newly diagnosed NSCLC patients with pulmonary oligo metastasis were randomly divided into two groups of A（treated with chemotherapy）and B（treated with sequential thoracic precise radiotherapy）.The patients had completed four platinum-based chemotherapy courses and received continuous chemotherapy for 1 or 2courses.The clinical efficacy,disease control rate,1-,2-,and 3-year survival rate,chest symptoms and radiotherapy and chemotherapy side effects were observed.Results The patients of groyps of A and B received continuous chemotherapy for a total of 56 and 50courses,respectively.The effectiveness rate,disease contril rate and 1-,2-and 3-year survival rate were higher in group A than those in group B（P〈0.05）.Group A had adverse effects ofⅠ,Ⅱ grade mostly and no chemotherapy-related death.Conclusion Compared to chemotherapy alone in the treatment of NSCLC patients with pulmonary oligo metastasis,the sequential thoracic precise radiotherapy has better efficacy with tolerable adverse effects.

关 键 词：非小细胞肺癌 寡转移 化疗 精确放疗 

分 类 号：R737[医药卫生—肿瘤]