Ⅲ期大体积非小细胞肺癌三维适形放疗尝试

A Trial for Large-Volume Stage Ⅲ Non-Small Cell Lung Cancer by 3-Dimensional Conformal Radiotherapy

目的 探讨以三维适形放疗（3DCRT）技术提高Ⅲ期大体积非小细胞肺癌的局控效果的可行性。方法 回顾分析应用3DCRT技术治疗的52例瘤体直径≥8cm的Ⅲ期非小细胞肺癌病例的治疗结果。42例行根治性放疗，BED72～112Gy；10例行姑息性放疗，BED48～70Gy。结果 44例临床状况明显改善。总的肿瘤局部控制有效率（CR＋PR）69．3％；根治病例为76．2％。无2级以上急性及晚期放射损伤（RTOG／EORTC分级标准）。结论 3DCRT是治疗Ⅲ期大体积非小细胞肺癌的安全有效的方法之一，可以提高肿瘤局控率。

Objective To investigate the effects of 3-dimensional conformal radiotherapy （3DCRT） in large-volume stage Ⅲ non-small cell lung cancer （NSCLC） .Methods Fifty two patients with stage Ⅲ NSCLC were treated by 3DCRT from June 1997 to June 2004. The tumor diameters were ≥ 8cm. Of the 52 patients, 42 cases received radical dose radiotherapy, with a biologically effective dose （BED） of 70 - 112 Gy ; 10 patients underwent palliative dose radiotherapy, with a BED of 48 - 70Gy. Results Forty four of the 52 patients had clinical state improvement （84.6%） . The local response rate （CR ＋ PR） was 69.3% in all of the 52 patients, 76.2% in patients treated with radical dose. No radiation related to toxicity of more than grade 2 （using toxicity criteria of RTOG/EORTC） was noted. Conclusions 3DCRT is a safe and effective treatment for large-volume stage Ⅲ NSCLC. We suggest its efficacy to improve the local control rate.