头体同步立体定向放射治疗老年非小细胞肺癌伴脑转移疗效分析  

Efficacy of the head and body stereotactic radiotherapy synchronous in the elderly NSCLC patients with brain metastases

作　　者：陈鑫[1] 丁广成[1] CHEN Xin;DING Guang-cheng(the Fifth Affiliated Hospital of Zheng- zhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第五附属医院伽玛刀科,河南省郑州市450052

出　　处：《实用老年医学》2018年第5期451-453,457,共4页Practical Geriatrics

摘　　要：目的探讨老年非小细胞肺癌(NSCLC)伴脑转移病人行头、体同步立体定向放疗(伽玛刀)后的局部病灶控制情况及不良反应情况。方法选取我院2014年1月至2017年6月期间住院的老年NSCLC伴脑转移的病人60例,分为2组,每组30例,观察组进行头、体同步立体定向放疗,对照组进行头、体同步三维适形放疗(3dimensional conformal radiationtherapy,3D-CRT)。比较2组治疗后的局部病灶控制情况及不良反应情况。结果观察组体部立体定向放射治疗(SBRT)后局部病灶控制率为93.5%,有效率为81.0%。颅脑转移灶行立体定向放射外科治疗(SRS)后局部控制率为95.4%,有效率为82.2%。观察组局部控制率、有效率均高于对照组(P<0.05),且不良反应发生率较对照组低。结论立体定向放疗作为一种有效、安全的局部治疗手段,对拒绝手术、化疗且未行靶向治疗的老年NSCLC伴脑转移病人具有良好的治疗效果。Objective To discuss the local lesion control and adverse reactions in the elderly nonsmall cell lung cancer（ NSCLC） patients with brain metastases who treated with head and body stereotactic radiotherapy synchronously（ gamma knife treatment）. Methods Sixty elderly NSCLC patients with brain metastases in our hospital from January 2014 to June 2017 were enrolled and divided into two groups,with thirty cases in each group. Observe group was treated with head and body sterotactic radiotherapy synchronously and the control group was treated with head and body 3 dimensional conformal radiationtherapy（ 3 D-CRT） synchronously. Local lesion control rate and adverse reactions were compared between the two groups. Results The local control rate and the effective rate of stereotactic body radiotherapy（ SBRT） in observation group was 93. 5% and 81. 0%,which of brain metastases focus was95. 4% and 82. 2% after sterotactic radiotherapy（ SRS） respectively. The local control rate and the effective rate were significantly higher and the incidence of adverse reactions were significantly lower than those of control group. Conclusions As a type of effective and safe local treatment method,SRS ＋SBRT shows the good treatment effects in elderly NSCLC patients with brain metastases who reject surgeries and chemotherapy,and have not been treated with targeting therapy.

关 键 词：老年人 非小细胞肺癌 立体定向放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]