超分割放射治疗局部晚期非小细胞肺癌的临床研究

CLINICAL STUDY OF HYPERFRACTIONATED IRRADIATION IN THE TREATMENT OF LOCALLY ADVANCED NON SMALL CELL LUNG CANCER (NSCLC)

目的探讨超分割放疗在晚期非小细胞肺癌治疗中的作用。方法超分割组：１２Ｇｙ／次，每日２次，间隔至少６ｈ，Ｄｒ７２Ｇｙ／６ｗ。常规组：２Ｇｙ／次，每天１次，Ｄｒ６４Ｇｙ／６４ｗ共３２次。两组均５ｄ／ｗ。结果超分割组和常规组总有效率分别为６４０％（１８／２８）和５７１％（１６／２８），无显著性差异（Ｐ＞００５）。随访３年，超分割组和常规组的一年、二年和三年生存率及局部控制率分别为６７９％、３２１％、２１４％和６４３％、４２９％、２８６％；４６４％、１７９％、１０７％和４２９％、２５０％、１７９％；均有显著性差异（Ｐ＜００５）。两组放射性食管炎和肺炎的发生率分别为５３６％、７１％和３２１％、１７９％，无显著性差异（Ｐ＞００５）。结论超分割放射治疗局部晚期非小细胞肺癌，反应轻微，患者均可耐受；并有提高肿瘤局部控制率和改善长期生存率的作用，疗效优于单纯常规放疗。

PURPOSE In order to evaluate the effect of hyperfractionated radiotherapy (HFI) and conventionally fractionated irradiation (CFI) for advanced NSCLC. METHODS The patients were irradiated by 1 2 Gy per fraction, twice daily with an interval of more than 6 hrs to a total does of 72Gy/60Fx/6w in HFI group. The patients or the CFI group were given a daily fraction of 2Gy, 5 times a week to a total dose of 64Gy/32Fx/6 4w.RESULTS The overall response rate in the HFI group and the CFI group were 64 0% (18/28) and 57 1% (16/28) respectively. The difference was not significant ( P >0 05). All of the patients were followed three years or more. The 1 , 2 , 3 year survival rates and local control rates respectively 67 9%, 32 1%, 21 4% and 64 3%, 42 9%, 28 6% in FHI group and were 46 4%, 17 9%, 10 7% and 42 9%, 25 0%, 17 9% in CFI group ( P <0 05). The incidences of esophagitis and pneumonitis in HFI group were 53 6% and 7 1%, and in CFI group they were 32 1% and 17 9% ( P >0 05).CONCLUSION The treatment results in HFI group were better than that in CFI gruop. HFI can improve 1 3 year survival rates and local control rates with minimal irradiation reactions, especially radiation pneumonitis.