局限期小细胞肺癌胸部放疗及放射损伤的研究现状

Current research of thoracic radiotherapy and radiation injury on limited small cell lung cancer

目的:总结国内外局限期小细胞肺癌(LSCLC)胸部放疗研究的现状。方法:应用PubMed和CHKD期刊全文数据库检索系统,以"局限期小细胞肺癌、胸部放疗和放射损伤"为关键词,检索1986-01-2008-04相关LSCLC胸部放疗的文献,共检索到英文文献430篇和中文文献187篇。纳入标准:1)LSCLC胸部放疗的疗效评价;2)LSCLC胸部放疗的方法;3)LSCLC胸部放疗与化疗结合的研究;4)LSCLC胸部放疗损伤的研究。根据纳入标准,精选82篇,最后纳入分析29篇。结果:配合胸部放疗可以提高LSCLC生存期,虽然胸部放疗的剂量、照射范围、分割方式、放化疗的顺序和最佳时机的选择等一直存有争议,但多数专家认为胸部放疗更为合理的方式为早期配合化疗(3个周期内)常规的累及野照射,剂量45～55Gy为宜。这几个热点问题也是引起胸部放疗损伤的重要因素。结论:胸部放疗在LSCLC的治疗中占重要地位,应选择适宜的放疗时机、合理的照射靶区和剂量,给予个体化治疗,以最小的放疗损伤获得最佳的治疗效果。

OBJECTIVE： To conclude current status of thoracic radiotherapy on limited small cell lung cancer. METHODS： By using limited small cell lung cancer, thoracic radiotherapy and radiation injury as key words, the documents about thoracic radiotherapy on limited small cell lung cancer between January 1986 and April 2008 in the PubMed and CHKD full text data base index systems were searched. The data selection： the data about the evaluation of effect and radiation injury of thoracic radiotherapy combined with chemotherapy on limited small cell lung cancer. Standard： 1）effect of radiotherapy on limited small cell lung cancer. 2）methods of radiotherapy on limited small cell lung cancer. 3）radiotherapy combined with chemotherapy for limited small cell lung cancer. 4）injury induced by thoracic radiotherapy on limited small cell lung cancer. According to the standard, 82 essays were selected from hundreds of papers on limited small cell lung cancer, and 28 gone into the analysis in the end. RESULTS： Thoracic radiotherapy can increase the survival of limited small cell lung cancer, but there is argument on when and how to radiate and these are also important factors on radiation injury. Most radiotherapists recommend early concurrent involved field thoracic radiotherapy combined with chemotherapy （within 3 cycles） and a recommended dose of 45 to 55 Gy. CONCLUSION： Thoracic radiotherapy pays a great importance on limited small cell lung cancer, although there are still some disputes about it.