后程适形放疗同步化疗治疗Ⅲ期非小细胞肺癌的临床观察

Late course conformal radiotherapy with concurrent chemotherapy for stage Ⅲ non-small cell lung cancer

目的：观察后程适形放疗同步化疗治疗Ⅲ期非小细胞肺癌的临床疗效及毒副作用。方法：对53例Ⅲ期非小细胞肺癌患者采用后程适形放疗同步化疗治疗。放射治疗先常规放疗2Gy/天/次,5次/周;至40Gy后改适形放疗,3Gy/天/,5次/周,共10次。化疗采用NP方案,每3周重复。结果：53例患者均完成治疗,CR5例（9.4%）,PR39例（73.6%）,总有效率（CR＋PR）为83.0%,1、2年生存率分别为81%和42%,局部控制率分别为85%和46%。放射性肺炎1-2级16例,3级1例;放射性食管炎1-2级26例,3级1例。结论：后程适形放疗同步化疗治疗晚期非小细胞肺癌能提高肿瘤局部控制率和近期疗效,并发症可以耐受。

Objective：To observe the effect and acute toxicity of late course conformal radiotherapy with concurrent chemotherapy for stage Ⅲ non-small cell lung cancer（NSCLC）. Methods： Total of patients with stage Ⅲ NSCLC received late course conformal radiotherapy combined with chemotherapy. The radiotheraphy consisted of two phases,40Gy in 20 fractions over 4 weeks as the first phase using conventional technique,and then 30Gy in 10 fractions over 2 weeks as the second phase using conformal radiation technique. Chemotherapy consisted of navelbine and cisplatin,3 weeks a cycle.Results： All 53 patients completed the therapeutic planned regimen and reached CR in 5 cases, PR in 39 cases, （CR＋PR） in 83.0%.1-year and 2 -year survival rates were 81%,42%,local control rates of 1-year and 2-year were 85%、46 %.In all cases, 16 had grade Ⅰ-Ⅱ radiation pneumonitis, 1 had grade Ⅲ pneumonitis,26 had grade Ⅰ-Ⅱ radiation esophagitis, 1 had grade Ⅲ esophagitis. Conclusion： Late course conformal radiotherapy combined with chemotherapy for stage Ⅲ non-small cell lung cancer can improve the local control rate and survival rate and complications were well tolerated.