108例老年人晚期非小细胞肺癌三维适形放射治疗的疗效分析

Clinical application of three dimensional conformal radiotherapy on advanced non-small cell lung cancer in 108 elderly patients

目的分析三维适形放射治疗（3D-CRT）在老年人非小细胞肺癌（NSCLC）的临床应用效果和放射损伤情况。方法接受3D-CRT的108例老年人晚期NSCLC中,男性102例,女性6例,中位年龄72岁。适形放疗单次剂量5～8Gy,隔日1次,总剂量68～82Gy。结果108例全部完成了放射治疗计划,完全缓解21例（19.4%）,部分缓解73例（67.6%）,无变化12例（11.1%）,恶化2例（1.9%）,总有效率87.0%。1、2、3年总生存率分别为65%、33%、28%。急性放射性肺炎2级8例,3级2例;晚期放射性肺炎2级11例,3级5例。结论采用3D-CRT技术治疗老年人晚期NSCLC有比较好的近期疗效,无严重的不良反应,有助于提高肿瘤的局部控制率,改善患者生存质量,减少并发症。

Objective To evaluate the therapeutic effects and radiation injuries of three dimensional conformal radiotherapy （3D-CRT） for elderly patients with advanced non-small cell lung cancer（NSCLC）. Methods From July 1999 to Sepember 2006, 108 elderly advanced NSCLC patients （median age, 72 years old） received 3D-CRT with a single dose of 5-8 Gy, once every two days and a total dose of 68 82 Gy. Results All 108 cases completed 3D-CRT treatment. The rates of complete response（CR）, partial response（PR）, no change（NC）, and progression（PD） were 19.4% （21/108）, 67.6% （73/108）, 11. 1% （12/108）, 1.9% （2/108）, respectively. Overall response rate （CR＋PR） was 87.0%（94/108）. 1-year, 2-year and 3-year survival rates were 65%, 33% and 28%, respectively. Grade Ⅱ acute radiation pneumonia were observed in 8 cases and grade m in 2 patients, grade Ⅱadvanced radiation pneumonia in 11 cases while grade Ⅲ in 5 cases. Conclusions 3D-CRT was effective and safe for elderly advanced NSCLS patients without operations because of contraindications or other problems.