大分割立体适形放疗非小细胞肺癌的临床分析

Accelerated hypofractionated three-dimensional conformal radiation therapy in the treatment of non-small cell lung cancer

目的分析非小细胞肺癌(NSCLC)立体适形放疗(3DCRT)大剂量分割的疗效与并发症.方法回顾性分析大剂量分割3DCRT治疗NSCLC 35例,6、8 Gy/次,隔日1次,3次/周,DT30～48Gy.结果 1、2、3年生存率分别为78.2%、46.9%、36.3%,1、2年无复发生存率分别为64.6%、39.7%.但放射性肺炎和肺纤维化的发生率较高,多因素Logistic回归分析显示V20与放射性肺炎的发生显著相关.结论3DCRT常规分割治疗较超大剂量分割治疗可能更适于多数NSCLC患者.

Objective To evaluate the effect and complication of non-small-cell lung cancer （NSCLC） treated with accelerated hypofractionated three dimensional conformal radiation therapy （3DCRT）. Methods There were squamous carcinoma 21, adenocarcinoma 7, squamous-adenocarciuoma 4 and other cancer 3. There were 17 stage I and 18 stage Ⅱ . Thirty-five patients of NSCLC were treated with a dose of 30-48 Gy in 6 or 8 Gy per fraction, 3 times a week. The outcome of these patients was analyzed. Results The overall 1-, 2- and 3- year survival rate was 78.2%, 46.9% and 36.3%, respectively. The 1- and 2-year recurrence-free survival rate was 64.6 % and 39.7 %, respectively. The acute radiation pneumonitis and late lung fibrosis rates were high. Univariate analysis showed that V20 was a significant predictor of acute radiation pneumonitis. Conclusion Compared with accelerated hypofractionated irradiation, the routine conventional fractionated radiation therapy may be preferred for more patients of NSCLC.