后程立体定向放射治疗非小细胞肺癌的临床探讨

Late course stereotactic radiosurgery for non small cell lung cancer

目的：比较后程立体定向放射治疗与常规放射治疗非小细胞肺癌的近期疗效和放射性肺炎的发生率。方法：对74例经病理确诊为NSCLC的患者分为常规放疗组（CRT组）44例,立体定向放疗组（LCSRT组）30例。LCSRT组：常规放疗DT40 Gy后对残存病灶采用立体定向放射治疗,5-8Gy/次,隔日1次,总量DT24-40Gy左右。CRT组采用常规分割放射治疗总量DT60-65Gy。结果：后程立体定向放疗组和常规放疗组的肿瘤消退总有效率和1年生存率分别为83.3%、59.1%及60%、34.1%,两组比较差异有显著性（P〈0.05）;2年生存率分别为20%和4.5%,差异无显著性（P〉0.05）;放射性肺炎分别为13.3%和22.7%,差异无显著性（P〉0.05）。结论：后程立体定向放疗治疗非小细胞肺癌近期疗效和1年生存率优于常规分割放射治疗,远期疗效和晚期并发症有待进一步观察。

Objective ：To compare the early response and the ratio of radioactive pneumonia of conventional radiotherapy and late course stereotactic radiosurgery for non small cell lung cancer. Methods ：Seventy-four patients with non small cell lung cancer were diagnosed by pathology, conventional radiotherapy group（CRT） was 44 examples, late course stereotactic radiosurgery group （LCSRT） was 30 examples. Late course stereotactic radiosurgery group（LC- SRT） was treated with the conventional radiotherapy of 40Gy followed by LCSRT to the residual lesion. In the same time, the conventional radiotherapy group（CRT） was treated with conventional radiotherapy, DT60- 65GY. Re- suits ：The effect rate and one-year survival rate of LCSRT group and CRT group were 83.3%, 59.1% and 60%, 34. 1%, respectively. There was significant difference in the two group （P〈0.05）. But two-year survival rate were 20% and 4.5%, respectively. There was not significant difference in the two group （P〉0. 05）. The ratio of radioactive pneumonia were 13. 3% and 22.7%, there was not significant difference in the two group （P〉0. 05）. Conclusions ： Recent effect and one-year survival rate of patients with non small cell lung cancer acceping LCSRT is better than that of patients acceping CRT . Remote results await further follow-up.