三维适形放疗联合化疗在非小细胞肺癌中的应用

Three - dimension conformal radiotherapy combined with chemotherapy for stage non - small cell lung cancer

目的观察三维适形放疗联合化疗治疗Ⅲ期非小细胞肺癌的临床疗效及毒副作用。方法对30例Ⅲ期非小细胞肺癌患者采用三维适形放疗联合化疗。放射治疗先常规放疗2Gy／（次·d），5次／周，至40Gy后改为适形放疗，3Gy／（次·d）．5次／周，共10次30Gy。化疗采用NP方案，分别于放疗前和放疗后给予2个周期，每3周重复。结果30例患者均完成治疗，CR2例，PR22例，总有效率（CR＋PR）为80％，一、二年局部控制率和生存率分别为81％、45％和78％、41％。放射性肺炎和放射性食管炎分别为19％和35％。结论三维适形放射疗法联合化疗对Ⅲ期非小细胞肺癌安全、有效，是治疗局部晚期非小细胞肺癌较理想的方案。

Objective To observe the effect and acute toxicity of late course three - dimension conformal radiotherapy （3DCRT） combined with chemotherapy for stage Ⅲ non -small cell lung cancer（NSCLC）. Methods Thirty patients with stage Ⅲ NSCLC received late course conformal radiotherapy combined with chemotherapy. The radiotherapy was divided into two phases, 40 Gy in 20 fractions over 4 weeks as the first phase using conventional technique, and then 30 Gy in 10 fractions over 2 weeks as the second phase using conformal radiation technique. Chemotherapeutic regimen consisted of navelbine and cisplatin, 3 weeks a cycle. Results All patients completed the therapeutic plan and reached CR in 4 cases, PR in 33 cases, （ CR ＋ PR） were 80%. 1 - year and 2 - year local control rates were 81% ,45% respectively, 1 - year and 2 - year survival rates were 78% , 41% respectively. Traditional pneumonitis and traditional esophagitis were 19% and 35%. Conclusion These data show that late course three - dimension conformal radiotherapy combined with chemotherapy is safe and effective for stage ⅢNSCLC patients. Three - dimension conformal radiotherapy combined with chemotherapy is a well tolerated reginen with acceptable toxicity and it is worthy of further elinical trial.