三维适形放疗同期化疗综合治疗局限期小细胞肺癌的临床观察

Clinical observation of three dimensional conformal radiation therapy （3D-CRT） concurrently combined with chemotherapy for limited stage small cell lung cancer

目的评价三维适形放射治疗同期化疗综合治疗局限期小细胞肺癌的疗效及不良反应。方法33例局限期小细胞肺癌患者行EP方案化疗，3周为1个周期，共行6个周期。放疗在化疗第1个周期或第3个周期同期进行，照射野包括原发病灶和纵隔，照射剂量45Gy／3周，每次1．5Gy，每天2次。结果33例入组患者同期放化疗毒性可耐受。总有效率（CR＋PR）97％。随访3年，中位生存时间为21．9个月，中位局部无进展生存时间为18．5个月，1、2、3年局部无进展生存率分别为66．7％、45．5％、30．3％，1、2、3年总生存率分别为69.7％、51．5％、30．3％。结论三维适形放射治疗同期化疗综合治疗局限期小细胞肺癌疗效较好，毒副反应患者能耐受，安全可行。

Objective To evaluate the efficacy and adverse effects of the three dimensional conformal radiation therapy（3D-CRT） concurrently combined with chemotherapy for limited stage small cell lung cancer（LSCLC）. Methods 33 patients with LSCLC received 6 cycles EP（cisplatin,etoposide） chemotherapy and 3 weeks was a cycle. The conventional radiotherapy was given after the first cycle chemotherapy or the third cycle chemotherapy, then the 3D-CRT and the total dose of the primary tumor was 45Gy per 3 weeks, 1.5Gy for once,twice for a day. Results Toxicity was durable in 33 patients received 3D-CRT concurrently combined with chemotherapy. The total response was 97 %. Median time was 21.9 months,and the 1- ,2- ,3-year survival rates was 69.7 % ,51.5 % ,30.3 %. The 1-, 2-, 3-year local progress ion-freely survival rates were 66.7 % , 45.5 % , 30.3 % , respectively, with the median local progression-freely survival time of 18.5 months. Respectively during three year follow-up visit. Conclusion The 3D-CRT concurrently combined with chemotherapy for patients with limited stage small cell lung cancer could be more effectively, and the patients could tolerate the side effects, this therapy method was secure and received.