小细胞肺癌预防性脑照射的远期疗效  

Long-term results of prophylactic cranial irradiation for limited-stage small-cell lung cancer in complete remission

作　　者：曹卡加[1] 黄惠英[1] 涂明耻[1] 潘国英[1] 

机构地区：[1]中山大学肿瘤防治中心放射治疗科,广州510060

出　　处：《中华放射肿瘤学杂志》2002年第4期224-226,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　探讨预防性全脑照射对局限期小细胞肺癌脑转移率和生存率的影响。方法　 51例经化疗加放射治疗后完全缓解的局限期小细胞肺癌病例被随机分为脑照射组 (2 6例 )和对照组 (2 5例 )。脑照射组在肿瘤完全缓解后 1 1～ 58d开始常规分割照射 ,采用双侧野照射 ,剂量为 2 5 .2～ 30 .6Gy。结果　脑照射组脑转移率为 3 .8% ,明显低于对照组的 32 .0 % (χ2 =5 .1 5 ,P =0 .0 2 )。脑照射组1、3、5年生存率分别为 84.6 %、42 .3 %、34 .6 % ,对照组分别为 72 .0 %、32 .0 %、2 4 .0 % ,两组比较差异无显著性意义 (χ2 =2 .2 5 ,P =0 .1 3)。脑照射组没有出现严重的放射后遗症。结论　预防性全脑照射能减少局限期小细胞肺癌的脑转移 。Objective To evaluate the effects of prophylactic cranial irradiation (PCI) on the survival and brain metastatic rates in patients with limited stage small cell lung cancer (SCLC) in complete remission. Methods Fifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into prophylactic cranial irradiation (PCI) group (n=26) and control group (n=25). Patients in PCI group received irradiation to a dose of 25.2～30.6?Gy by 1.8～2.0?Gy per fraction. With the survival rates of the two groups analyzed by life table and compared by Log Rank test, the difference in cranial metastatic rates between the two groups were tested by χ 2 test. The patients' clinical features such as age, sex, effect of treatment before PCI were comparable between the two groups. Results The incidence of cranial metastasis was 3.8% in the PCI group as compared with 32.0% in the control group, with the difference significant (χ 2=5.15, P= 0.02 ). The 1 , 3 , 5 year survival rates were 84.6%, 42.3%, 34.6% in the PCI group and 72.0%, 32.0%, 24.0% in the control group, with no significant difference between the two groups (χ 2=2.25, P=0.13). No serious complications were observed in patients who received PCI. Conclusion For patients with limited stage SCLC complete response after chemoradiotherapy, PCI can decrease the incidence of cranial metastasis and tends to improve the survival rate.

关 键 词：小细胞肺癌 预防性脑照射 疗效 放射疗法 

分 类 号：R734.2[医药卫生—肿瘤] R730.[医药卫生—临床医学]