三维适形放射治疗肺癌脑转移疗效分析

Analysis of therapy effiency affecting 3-Dimentional Conformal radiotherapy after brain metastases from lung cancer

[目的]探讨三维适形对肺癌脑转移的有效治疗方法。[方法]将病理诊断明确的肺癌脑转移患者39例分成2组，三维适形放射治疗3D-（CRT）19例，三维适形放射治疗前加全脑放疗（WBRT4-3D-CRT）20例，3D-CRT治疗单次靶区平均周边剂量3～8Gv，总剂量40～60Gy；WBRT4-3D-CRT组：3D-CRT治疗单次靶区平均周边剂量同前，但总剂量为16～32Gy，在3D-CRT之前WBRT2～3Gv／次，总剂量30～40Gv／3～4w。[结果]3D-CRT和WBRT4-3D-CRT肿瘤局部控制率分别为84.3％和85％（P〉0.05），中位生存期分别为11和12．5个月（P〉0．05）。[结论]全脑放疗加三维适形放射治疗（WBRT4-3D-CRT）和三维适形放射治疗（3D-CRT）在肿瘤局部控制率和生存期上无明显差别。

[ Objective] To explore the effiencent methods after treatment of brain metastases from lung cancer, with three dimentional radiotherapy. [ Methods] Thirty - nine patients with brain metastes from lung cancer affirmed by pathology were divided into two groups： 19 patients were received 3D- CRT and 20 patients were received 3D- CRT ＋ WBRT, the patients of 3D- CRT groups received single target dose ranging from 3 - 8 Gy, with a total dose of 40 - 60 Gy ; WBRT ＋ 3D - CRT ： the total dose of whole brain radiotherapy （WBRT）was 30 - 40 Gy with 2 - 3 Gy per fraction,after that single target dose ranging from 3 - 8 Gy,with a total dose of 16 - 32 Gy. [ Results] the local tumor control rates of 3D - CRT and WBRT ＋ 3D - CRT was84.3 % and 85 % （ P 〉 0.05）, the median suvival time was 11 and 12.5months（ P 〉 0.05）, [ Conclusion]3D - CRT and WBRT ＋ 3D - CRT are the same in improving the local control rates and survival time.