肺癌术后支气管切缘阳性病例术后放疗疗效分析

Effect of stereotactic radiotherapy for patients with non-small cell lung cancer with positive stump at the resected bronchial margin

目的评价立体定向放疗配合常规放疗对非小细胞肺癌术后支气管切缘阳性患者的疗效。方法共搜集非小细胞肺癌术后支气管切缘阳性患者41例,对其中18例在常规放疗后采用立体定向放疗进行缩野治疗(RT+SRT组),而将另外23例单纯采用常规放疗的作为对照(RT组)。结果RT+SRT组1、2、3年局部无复发率分别为92.3%、83.1%、83.1%,RT组为80.2%、60.2%、39.5%;RT+SRT组1、2、3年生存率分别为70.6%、58.5%、41.2%,RT组为68.7%、45.8%、22.9%。RT+SRT组的局部复发率明显低于RT组,而2个组间的并发症发生率和生存率的差异均无显著性意义。结论对非小细胞肺癌术后支气管切缘阳性患者,立体定向放射治疗可作为常规放疗后局部增量的有效手段,它可能有助于进一步提高局部控制率。

Objective To evaluate the effect of stereotactic radiotherapy combined with conventional radiotherapy for non-small cell lung cancer(NSCLC)patients with positive stump at the resected bronchial margin. Methods From June 1996 to November 2000, 41 NSCLC patients in whom microscopic residual disease found pathologically at the resected bronchial margin were treated by: conventional radiotherapy followed by stereotactic radiotherapy ( RT+SRT group 18 patients), while the other 23 patients received routine radiotherapy alone (RT group). Results The 1-,2-and 3-year local disease-free rates were better in RT+ SRT group (92.3%,~83.1% and 83.1%) than those in RT group (80.2%,60.2% and 39.5% ). However, no significant difference was found in the complication rate or survival rate between the two groups. Conclusions Stereotactic radiotherapy is effective as a boost irradiation to patients with non-small cell lung cancer with microscopic residual disease at the resected bronchial margin by improving the local control.