老年性非小细胞肺癌适形放疗与化疗的疗效分析

Effective analysis of three-dimensional conformal radiotherapy plus chemotherapy for treating elderly non-small-cell lung cancer

目的比较62例老年性非小细胞肺癌适形放疗加化疗与单纯放疗的疗效差异。方法分析2005年7月至2007年6月老年性（〉65岁）非小细胞肺癌患者62例，其中31例接受放化疗，化疗方案采用紫杉醇加顺铂；31例仅采用单纯放疗。结果患者中位随访时间为2年，治疗后3个月、1年、2年复查，放化疗组局部控制率（局控率）67．7％，单纯放疗组局控率61．3％；Kaplan-Meier生存率计算，放化疗组两年生存率为83．9％，单纯放疗组两年生存率为77．4％。两组患者RTOG 2～3级放射性肺炎的发生率分别为16．1％与9．7％，差异无统计学意义（P〉0．05）；两组患者白细胞下降发生率分别为45．2％与16．1％，差异有统计学意义（P〈0．05）。结论对于不能耐受手术、化疗的非小细胞肺癌三维适形放疗是一种有效的治疗手段，可提高局部控制率，改善患者的生存质量。在本组研究中，放化疗组与单纯放疗组比较，并未提高患者两年生存率。

Objective To compare three-dimensional conformal radiotherapy（3D-CRT） plus chemotherapy and 3D-CRT in 62 aged patients with non-small-cell lung cancer（NSCLC）. Methods From Jul. 2005 to Jul. 2007,62 of aged patients with NSCLC in our department were retrospectively analyzed. Among them, 31 cases received 3D-CRT plus chemotherapy and 31 cases received 3D- CRT only. Results The median follow-up was 48 months. After the end of treatment, the patients received 3-month, 1-year and 2- year review of the relevant inspection. The local control rate was not statistically different between the two groups （67. 7% vs 61.3%）. The Kaplan-Meier survival rate,two-year survival rates in 3D-CRT plus chemotherapy group were 83.9% and 77.4% ,in radiotherapy group. Radiation pneumonitis of RTOG grade 2-3 occurred in two groups was not statistically different（P〉0.05）. The decline of leucocyte in two groups was statistically different（P〈0.05）. Conclusion To the aged NSCLC patients who can not tolerate surgery and chemotherapy,3D-CRT can improve local control and quality of life. However, the survival rate in this study does not increase.