肿瘤体积和放疗剂量对局部晚期非小细胞肺癌三维适形放疗预后影响.docVIP

肿瘤体积和放疗剂量对局部晚期非小细胞肺癌三维适形放疗预后影响 　　【摘要】 目的 探讨肿瘤体积和放疗剂量对局部晚期非小细胞肺癌（NSCLC）三维适形放疗（3D-CRT）预后的影响。方法 78例接受3D-CRT的局部晚期NSCLC患者为研究对象， 利用三维适形放射计划系统和CT扫描勾画相应靶区， 分别定义为GTV-T、GTV-P和GTV-N， 分析各靶区肿瘤体积和放疗剂量对3D-CRT的预后效果。结果 全组研究对象中肿瘤最大直径5.00 cm的患者生存率高于肿瘤最大直径≥5.00 cm的患者（P0.05）；GTV-T100.00 cm3的患者生存率明显高于GTV-T≥100.00 cm3的患者（P0.05）。分层分析显示放疗处方剂量≤66 Gy亚组中， 肿瘤大体体积越小， 生存率越高。结论 应用三维适形放射计划系统和CT扫描所勾画的大体肿瘤体积对接受放疗的NSCLC患者长期生存率有显著影响；对体积小的肿瘤行大剂量放疗对局部晚期NSCLC患者的生存有益。 　　【关键词】 肿瘤体积；非小细胞肺癌；肺癌预后；放疗剂量 　　DOI：10.14163/j.cnki.11-5547/r.2015.27.001 　　Influence of gross tumor volume and radiotherapy dose on prognosis of three dimensional conformal radiation therapy for locally advanced non-small cell lung cancer LIU Xing-xiang. Department of Oncology， Taizhou City the Second People’s Hospital， Taizhou 225500， China 　　【Abstract】 Objective To investigate influence of gross tumor volume and radiotherapy dose on prognosis of three dimensional conformal radiation therapy （3D-CRT） for locally advanced non-small cell lung cancer （NSCLC）. Methods There were 78 locally advanced NSCLC patients receiving 3D-CRT as study subjects. Three dimensional conformal radiation planning system and CT screening were applied for delineating corresponding target sections， as GTV-T， GTV-P and GTV-N. Gross tumor volume and radiotherapy dose in each target section were analyzed for their prognosis effects. Results Patients with tumor diameter 5.00 cm had higher survival rate than those with tumor diameter ≥5.00 cm （P0.05）. Patients with GTV-T 100.00 cm3 had obviously higher survival rate than those with GTV-T ≥100.00 cm3 （P0.05）. Stratification analysis showed that in subgroup with radiotherapy dose ≤66 Gy， the survival rate increased while gross tumor volume declined. Conclusion Gross tumor volume shown by three dimensional conformal radiation planning system and CT screening has remarkable influence on long-term survival rate in NSCLC patients. It is also beneficial for locally advanced NSCLC patients receiving large radiotherapy dose