非小细胞肺癌三维适形放疗不同剂量分割临床研究

Clinical observation of three-dimensional conformal radiation therapy of different dose fractionation in the treatment of non-small cell lung cancer

目的观察非小细胞肺癌(NSCLC)三维适形放疗(3DCRT)不同剂量分割的疗效和副作用。方法41例II^IIIb期NSCLC随机分为两组,均采用3DCRT,A组22例,剂量分割为2.0~2.4Gy/次,1次/天,5天/周,总剂量66~72Gy。B组19例,剂量分割为4.0~4.4Gy/次,1次/天,5天/周,总剂量44~48Gy。结果A组和B组即期有效率分别为81.8%和94.7%,1年生存率分别为54.5%和57.9%,放射性肺炎发生率分别为13.6%和26.3%,两组放射性食管炎发生率分别为31.8%和47.4%。骨髓抑制A组13.6%,B组15.8%。两组疗效和副作用差异无显著性。结论非小细胞肺癌三维适形放疗2.0~2.4Gy/次和4.0~4.4Gy/次的剂量分割近期疗效相似,副作用均较轻,远期疗效和并发症有待进一步观察。

Objective To evaluate the clinical effect and toxicity of three - dimension conformal radiation therapy （3DCRT） of different dose fractionation in the treatment for stage Ⅱ -Ⅲ non - small cell lung cancer （NSCLC）. Methods Forty one （41） patients with stage Ⅱ -Ⅲ NSCLC were divided randomly into two groups： A group and B group, all were treated with 3DCRT. A group： had 22 patients which received a dose of 66 -72Gy at 2 - 2.4Gy per fraction , five （5） times a week; B group： 19 patients received a dose of 44 -48Gy at 4 - 4.4Gy per fraction , 5 times a week. All patients received 2 to 3 cycles with cisplatin and navelbine before 3DCRT. Results The overall response rate （ CR ＋ PR） were 81.8% and 94.7% in A group and B group, 1 year survival rates showed 54.5% and 57.9% in A and B group. Toxicity was similar in A and B group. Conclu- sion 3DCRT is safe and effective with 2 - 2.4Gy/fraction and 4 - 4.4Gy/fraction. The short - term effect is satisfactory. Long - term result needs further follow - up.