全身化疗同期腔内放射治疗中晚期中央型肺癌的临床观察

Clinical observation of advanced central lung cancer treated by endobronchial brachytherapy combined with systemic chemotherapy

目的 采用全身化疗同期支气管腔内近距离放射治疗中、晚期中央型肺癌,评价近期疗效和不良反应.方法 36例肺癌患者选用含铂类为主的方案全身化疗期间同时进行腔内局部放疗3～4次（1次/周,单次剂量6～7Gy）.结果 36例患者完全缓解24例,部分缓解9例,总有效率RR为91.7%.对不同病理类型肺癌疗效无显著性差异;症状改善好转率77.8%,稳定率22.2%.不良反应主要为骨髓抑制和放射性气管炎.结论 全身化疗同期支气管腔内放射治疗中、晚期中央型肺癌, 近期效果明显,临床症状迅速改善,病人生活质量明显提高,可安全应用于临床.

[Abstract] Objective To evaluate the short term eficacy and toxicity of endobronchial brachytherapy in combination with systemic chemotherapy in the treatment of advanced central lung cancer. Methods Thirty - six patients suffering from endobronchial obstruction caused by lung cancer were included in this study. Treatment consisted of cisplatin- based combinations and endobronchial brachytherapy concomitantly（6- 7Gy per fraction; once a week;for 3 to 4wceks）. Results Total response rate was 91.7 %, with CR for 24 and PR for 9. There were no significant difference among various phathological types. Twenty - eight patients achieved symptomatic palliation （77.8%）. The main toxicities were myelosuppression and radiation bronchitis. Conclusion Endobronchial brachytherapy combined with systemic chemotherapy is effective in patients with advanced central lung cancer. It can alleviate symptoms rapidly , promote the quality of life and can be used safely.