大分割适形放疗和常规分割放疗对非小细胞肺癌原发灶的疗效分析  

Therapeutic effect of high-dose three-dimensional conformal radiotherapy and conventional radiotherapy for non-small-cell lung cancer

作　　者：徐素俊[1] 石玉生[1] 宋海春[2] 陈龙华[1] 

机构地区：[1]第一军医大学南方医院放疗科,广东广州510515 [2]吉林市第二人民医院核医学科,辽宁吉林132002

出　　处：《第一军医大学学报》2002年第10期937-938,.941,共3页Journal of First Military Medical University

摘　　要：目的探讨提高非小细胞肺癌放射治疗疗效而不增加放射损伤的方法.方法135例非小细胞肺癌患者中62例行大分割适形放疗,6～8 Gy/次,隔日1次,总剂量48～64 Gy,共6～8次,总疗程2～3周;73例行常规分割放疗,2 Gy/次,5次/周,总剂量60～70 Gy,共30～35次,总疗程6～7周.对比观察治疗后1、2年肺内局部病灶控制率、生存率以及放射性肺、食道损伤发生率.结果放疗后3个月,常规分割放疗组和大分割适形放疗组病灶完全消失率分别为44.9%和77.8%,有效率分别为94.4%和100%,两组治疗效果有显著差异(P＜0.01);两组1年生存率分别为42.5%和77.8%(P＜0.01),2年生存率分别为30.1%和48.6%(P＜0.01),两组局部病灶控制率有显著差异(P＜0.01);两组放射性肺、食道损伤发生率无统计学差异.结论非小细胞肺癌大分割适形放疗疗效优于常规分割放疗.Objective To improve the therapeutic effect of radiotherapy without increasing the risk of radiation injury in patients with non-small cell lung cancer (NSCLC). Methods From August 1998 to August 1999, 135 patients with NSCLC received radiotherapy, of whom 62 were treated with high-dose three-dimensional conformal radiotherapy (3D-CRT) at the total dose of 48 to 64 Gy in 6 to 8 fractions implemented in a course of 2 to 3 weeks, 6 to 8 Gy for each fraction. The other 73 patients underwent conventional radiotherapy (CR) at the total dose of 60 to 70 Gy in 30 to 35 fractions completed in 6 to 7 weeks. Follow-up study was conducted in all the cases, and CT-scan or magnetic resonance imaging was performed once every 3 months after the therapy to assess the local control rate, survival rate, radiation-induced lung and esophageal injuries. Results Three months after radiation therapy, complete remission of the lesions was achieved in 44.9% (CR group) and 77.8% (3D-CRT group) of the cases with the efficacy rates of 94.4% and 100% respectively, showing significant differences between the 2 groups (P<0.01). The 1- and 2-year survival rate of the patients in the 2 groups were 42.5% vs77.8% and 30.1% vs48.6% respectively, also with significant differences between the 2 groups (P<0.01). Significant difference also occurred in the 1- and 2-year local control rates between the 2 groups, but not in the incidences of radiation-induced lung and esophageal injuries. Conclusion3D-CRT may yield better therapeutic effect than CR does and has comparable safety with the latter.

关 键 词：非小细胞癌 放射疗法 适形 放射治疗剂量 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学]