立体定向放射治疗II期非小细胞肺癌的临床研究

Clinical research of stereotatic radiotherapy for stage Ⅱ Non-small cell lung cancer(T3N0M0)

目的评价立体定向放射治疗Ⅱ期(T3N0M0)非小细胞肺癌的疗效和放射反应。方法对46例II期(T3N0M0)非小细胞肺癌患者采用全身伽玛射线立体定向放射治疗系统进行立体定向放射治疗。剂量(50%剂量线)4~5Gy次/,隔日1次,共8~10次,总剂量40~50Gy。结果46例患者总有效率为89.1%(41/46),其中完全缓解率为52.2%(24/46),1、2年总生存率分别为82.6%(38/46)、71.7%(33/46),2年无复发生存率分别为69.6%(32/46)和65.2%(30/46)。早期放射反应主要为骨髓抑制和肺的早期放射反应,骨髓抑制8例(I度5例,II度3例),主要是白细胞和血小板减少;肺的早期放射反应6例(I级4例,II级2例)。晚期放射反应主要为照射区域局限性放射性肺炎,I^II级放射性肺炎16例,III级放射性肺炎7例,食道、心脏、脊髓未观察到晚期放射反应。结论全身伽玛射线立体定向放射治疗系统治疗II期(T3N0M0)非小细胞肺癌患者近期疗效好,放射反应轻,其远期疗效和晚期放射损伤有待于进一步观察。

Objective To evaluate the clinical effects and radiation reaction of stereotatic radiotherapy for stage Ⅱ Non-small cell lung cancer. Methods A total of 46 cases of non-small-cell lung cancer were treated with stereotactic gamma ray body therapeutic system. Dosage （50%） to the total close of 40 - 50Gy with 4 - 5 Gy refraction treated every other day, 8 - 10 times. Results The overall response rate（CR ＋PR）in 46 cases was 89.1% （ 41 / 46） ,CR：52.2% ; The 1,2 -year survival rates were 82.6% （38/46） , 71. 7% （33/46） , the disease-free rates were 69.6% （32/46） and 65.2% （30/46）. The primary radiation reaction is marrow depression, and primary lung radiation reaction. There are 8 marrow depression cases in these groups, （degree Ⅰ ： 5 cases, degree Ⅱ ： 3 cases）. Leukocyte and haematoblast decreased in these cases. Primary lung radiation reaction cases is 6（ degree Ⅰ ： 4 cases, degree Ⅱ： 2 cases）. Late-course radiation reaction is local radiation pneumonia in irradiation region （ degree Ⅰ -Ⅱ ： 16 cases, degree Ⅲ ： 7 cases）. The radiation reaction were not observed in esophagus, heart, and spinal cord. Conclusion The stereotatic radiotherapy was effective for stage Ⅱ （T3NOMO） Non-small cell lung cancer patients. The radiation reactions were mild. The prospective efficacy and late-course radiation reaction damage need further observation.