伽玛刀联合化疗治疗中晚期肺癌近期疗效观察

Short-term therapeutic effectiveness of body γ-knife combined with concurrent chemotherapy in patients with Advanced NSCLC

目的探讨体部伽玛刀联合同期化疗治疗中晚期非小细胞肺癌的近期疗效观察。方法64例患者均采用体部伽玛刀放疗,总量35～45 Gy,分10～14次完成,每日一次,每周5次;同期行全身化疗,采用NP方案,28天为一周期,每位病人至少完成2个周期化疗,伽玛刀治疗结束后3月评价疗效。结果64例患者近期总有效率(CR+PR)为93.75%(60/64)。急性放射性肺损伤9.38%(6/64),为1～2度;急性放射性食管损伤的发生率为7.81%(5/64),为1～2度;血液毒性主要为白细胞下降,3度发生率为12.50%(8/64),无4度血液毒性发生。随访36个月,1、2、3年生存率分别为60.94%(39/64)、40.63%(26/64)和32.81%(21/64)。结论采用体部伽玛刀联合同期化疗治疗中晚期肺癌,具有较高的近期疗效,毒副反应较轻,患者可以耐受。

Objective To observe the short-term curative effects of body γ-knife combined with concurrent chemotherapy for treatment of advanced non-small cell lung cancer（NSCLC）. Methods All 64 patients were treated with body γ-knife combined with con- current chemotherapy. Radiation was delivered in 10 to 14 fractions with a cumulated marginal dose ranged 35 -45 Gy. ＂NP＂ project were given with body γ-knife,28 days per cycle. At least 2 cycles were delivered. Clinical effects were evaluated three months after the γ-knife treatment. Results The total efficacy rate was 93.75%. Acute radiation induced lung injury was 9. 38% （ Ⅰ-Ⅱ ） ;acute radiation induced esophagus injury was 7.81% （Ⅰ-Ⅱ ） ;bone-marrow toxicity 12.50% （ Ⅲ ）. In the follow-up of 36 months,the survival rates at 1, 2,3 year were 60. 94% ,40.63% and 32. 81% ,respectively. Conclusion Body γ-knife combined with concurrent chemotherapy is a feasible, safe, and effective method and could be well tolerated in most patients. It is a good treatment for patients with advanced lung cancer and deserves further investigation.