体部γ-刀治疗Ⅰ-Ⅱ期非小细胞肺癌的临床研究  

Clinical experience of body gamma knife for the treatment of non-small cell lung cancer: preliminary results of a pilot study

作　　者：夏廷毅[1] 孙庆选[1] 李平[1] 于勇[1] 崔纪青[1] 范乃斌[1] 

机构地区：[1]空军总医院,北京100036

出　　处：《空军总医院学报》2003年第2期81-84,87,共5页Journal of General Hospital of Air Force,PLA

摘　　要：目的　观察评价体部 γ-刀治疗 - 非小细胞肺癌的近期疗效和放射反应。　方法　对 2 8例 - 期非小细胞肺癌采用我国深圳奥沃公司生产的旋转式体部 γ-刀治疗 ,治疗时采用体架和真空负压袋固定体位、CT定位和三维计划。照射剂量肿瘤边缘 (5 0 %剂量线 ) 5 Gy/次 ,5次 /周 ,肿瘤局部总剂量 4 0～ 5 0 Gy。　结果　原发灶的完全缓解率 (CR) 6 7.9% (19/ 2 8) ,部分缓解率 (PR) 32 .1% (9/ 2 8) ,总有效率 10 0 %。 2 8例全部按计划完成治疗 ,放射反应较轻 ,急性放射性食道炎占 2 5 % (7/ 2 5 ) ,其中 级占 17.9% , 级占 7.1% ;放射性肺炎多数较轻 , 级占 2 5 % (7/ 2 8) , 级占 10 .7% (3/ 2 8)。 1、2年肿瘤局部控制率和生存率分别为 92 .3%、6 8.8%和 82 .1%、71.4 %。　结论　体部伽玛刀治疗早期非小细胞肺癌近期疗效好 ,放射反应轻 ,能为所有患者耐受 ,是一种有效安全的局部治疗手段之一。其远期疗效和晚发性放射损伤有待进一步观察评价。Objective In order to evaluate the early response and acute radiation reaction of bodyγ knife for the treatment of non small cell lung cancer. Methods From June 2000 to May 2001, 28 patients with stage Ⅰ Ⅱ Non Small Cell Lung Cancer (NSCLC) were treated with the Stereotactic Gamma Ray Whole Body Therapeutic System (Body γ knife, QGD; OUR International Technology & Science Co., LTD, Shenzhen, China). For body γ knife treatment a stereotactic body frame for exact tumor localization, reproducible fixation, CT simulation and 3 D treatment plan has been developed. Body γ knife fraction schema periphery dose 3～8 Gy per day (50% dose line), 5 day a week was employed, at a total dose of 40～50 Gy. Results All patients treated with body γ knife were analyzed to evaluate the early responses and acute complications. The complete response rate (CR) in the primary tumor was 67.9%, and the overall response rate (CR+PR) was 100% after 2～3 months of radiotherapy. Acute radiation induced esophagitis occurred in 25% of patients ( Grades Ⅰ 17.9% (RTOG), Grade Ⅱ 7.1%). Acute radiation induced pneumonitis was observed in 35.7% of patients [Grade Ⅰ 25% (RTOG), Grade Ⅱ 10.7% ]. The 1 , 2 year local control rates and 1 , 2 year survival rates were 92.3%, 68.8% and 82.1% and 71.4%, respectively. Conclusion This new technology, which is noninvasive, painless, and rapid and does not require hospitalization, does not impair the quality of life of the patients when used properly. Treatment has obtained a high response rate with minimal side effects. Remote results await further follow up.

关 键 词：体部γ-刀 治疗 Ⅰ-Ⅱ期 非小细胞肺癌 临床研究 

分 类 号：R734.2[医药卫生—肿瘤]