晚期非小细胞肺癌放疗结合热疗对比临床研究

Radiotherapy combined with external high frequency thermo-therapy in the treatment of advanced non-small cell lung cancer

目的 对比研究晚期非小细胞肺癌体外高频HG-2000热疗结合放疗的初步临床探讨。方法 分析2002～2004晚期非小细胞肺癌患者54例，随机分为A、B两组：A组为放疗组；B组为热放综合治疗组。A组27例，采用6MV-X线常规分割放疗或立体适形放疗，照射至肿瘤剂量DT40．0～45．0Gy时，缩野避开脊髓放疗至肿瘤总剂量DT60—65Gy，5—7周完成。B组27例，放疗期间同时结合高频HG-2000体外热疗机增敏热疗，放疗方法及剂量与A组相同。热疗在每次放疗前或放疗后1小时内进行。温度控制在41．5—43℃，肿瘤中心温度45-53℃，60min／次，2次／周，2次间隔72h以上，每疗程6—10次。结果近期疗效：治疗结束后1—3个月以CT检查的影像学结果为依据，判断近期疗效。有效率（CR＋PR）放疗组与综合组分别是74％、82％；无效率（NC＋PD）放疗组与综合组分别是6％、0％。生存率：1、2年生存率放疗组和综合组分别为84、5％、50、7％和87．3％、52．3％。中位生存期分别为17．5和18．2个月，2组比较差异无显著性意义（X。=4、25，P=0．053）。毒副反应：皮肤反应，热疗组轻度烫伤2例，Ⅱ度烫伤1例；急性放射性肺炎，放疗组54例，热放组62例。1-2级骨髓抑制，放疗组19．6％，热放组18．8％。结论高频热疗结合放疗治疗局部晚期非小细胞肺癌疗效优于单纯放疗。放射性肺炎发生率有待进一步探讨。

Objective To study the clinical effect of radiotherapy combined with external high frequency thermo-therapy in the treatment of later non-small cell lung cancer. Methods To analyse 54 NSCLC patients 2002 - 2004, grouped randomly into A and B, A therapied with radiotherapy, B with radiotherapy combined with external high frequency thermo-therapy. A 27 cases, when DT 40.0 - 45.0 Gy, reduce the area and avoid the spinal cord DT 60. 5 - 65.0 Gy/5 - 7 w. B 27 cases, given 60 minutes thermo-therapy after or before radiotherapy in 1 hour twice/w, every 72 hours, 6 - 10/cure course, temperature 41.5 43℃, tumor center 45 ～ 53℃. Results Recent effect ： 1 - 3 months ＇after therapy, according to CT results. CR ＋ PR A, B 74%, 82%; NC＋PD6%, 0%. Survialrate： 1 and2 year A, B84.5%, 50. 7%; 87. 3%, 52. 3%. medialsurvial rate A, B 17.5 and 18.2 months, no statistically significant （P 〈0. 053）, Skin scald： group B grade Ⅰ 2 cases, grade 11 1. Acute radio-pneumonia： A 54 cases, B 62 cases. Ⅰ～Ⅱ leukopenia： A 19. 6% , B 18.8%, Conclusion The treatment of advanced non-small cell lung cancer with radiotherapy eompbined with external high frequency thermo-therapy is better than only radiotherapy. Acute radio-pneumonia needs further study.