三维适形放射治疗34例非小细胞肺癌临床疗效剖析.docVIP

三维适形放射治疗34例非小细胞肺癌临床疗效剖析 　　【中图分类号】R734.2【文献标识码】A【文章编号】1005-2720(2009)03-0001-03 　　【摘要】目的：评价非小细胞肺癌(NSCLC)三维适形放射治疗的近期临床疗效以及毒副反应。方法：34例中晚期非小细胞肺癌患者，先常规对原发灶、肺门、纵隔淋巴结前后对穿野照射40Gy，再采用三维适形放疗(3DCRT)24～30Gy/12～15次，2Gy/次，累积量达DT64～70Gy，观察三维适形放射治疗之后近期临床疗效，以及放射性损伤等毒副反应与照射剂量和照射体积的关系。结果：34例患者CR26.5%(9/34)，PR50.0%(17/34)，NC11.8%(4/34)，PD11.8%(4/34)，总有效率(CR+PR)76.5%(26/34)，肿瘤靶区放疗剂量提高了10%～20%。1年生存率为67.0%，1年局部控制率72%。1级放射性肺炎5例，2级放射性肺炎1例，急性放射性食管炎Ⅰ～Ⅱ度5例，Ⅲ度0例。骨髓抑制Ⅰ～Ⅱ度4例。结论：对中晚期非小细胞肺癌三维适形放疗有较好的近期疗效，通过增加靶区照射剂量，提高了肿瘤控制率，V20≤30%是安全的，副反应可耐受，远期效果尚需进一步观察。 　　【关键词】非小细胞肺癌；三维适形放疗；放射性肺炎 　　 　　The study of clinic therapeutic effect about three -dimensional conformal radiation therapy for 34 patients with non-small cell lung cancer.Luo Fengling，Quan Yi，Wu Huangjian，et al.(The first people’s hospital of Zhaoqing，Guangdong 526021) 　　【Abstract】Objective：To evaluate the therapeutic efficacy and radiation complications of three dimensional conformal radiotherapy in patients with non-small cell lung cancer.Methods：34 patients with non - small cell lung cancer received radiotherapy at the total doses of 64~70 Gy，first conventional radiotherapy at the doses of 40 Gy，then in the late course three dimensional conformal radiotherapy at the dose of 24 to 30 Gy in 12 to 15 fractions (2Gy per fraction).And to observe the therapeutic efficacy，radiation complications and the relationship with the prescription doses and the volume of the doses.Results：The complete response rates were 26.5%(9/34)，the part response rates 50.0% (17/34)，the no change rates 11.8% (4/34)，the progressive disease rates 11.8% (4/34).The total efficacy rates were 76.5%(26/34).And the 1-year survival rates of the 34 patients were 67.0%.The major radiation complications observed in the 34 patients were radiation pneumonitis grade Ⅰin 5 patients，grade Ⅱ in 2 patients，and acute radiation esophagitis grade Ⅰto Ⅱin 5 patients，myelosuppression grade Ⅰto Ⅱin 4 patients.Conclusion：Using three dimensional conformal radiotherapy for patients with advanc