26例非小细胞肺癌调强放疗的近期疗效和毒副反应

Short-Term Outcomes and Toxicities of Intensity Modulated Radiation Therapy in the Treatment of 26 Patients with Non-Small Cell Lung Cancer

目的分析应用调强放疗(IMRT)技术治疗非小细胞肺癌(NSCLC)患者的近期疗效和毒副反应。方法应用IMRT技术治疗26例不能手术或不愿手术的NSCLC。肿瘤GTV的中位体积为280.2(46.2～689.3)cm3,所有患者均接受2.0～2.5 Gy/次的分割;1次/d;5次/周;4～7周完成治疗,中位总剂量为55.2(33～70)Gy,均采用5野的调强放疗。结果 26例患者均完成了放疗计划。中位随访时间为8.2(4～21)个月,1年生存率65.4%。放疗结束后3个月时的肿瘤局控情况:CR 1例(3.8%);PR 19例(73.2%);SD 3例(11.5%);PD 3例(11.5%),其中死亡1例(3.8%)。最常见的毒副反应为放射性肺炎和放射性食管炎。结论应用5野IMRT技术治疗NSCLC可行、有效,毒副反应可耐受。

Objective To retrospectively analyze short-term outcomes of the patients with non-small-cell lung cancer（NSCLC）.They were treated with intensity modulated radiation therapy（IMRT）.Methods 26 patients with NSCLC who were unable or unwilling to received operation with IMRT.GTVs was 280.2 cm3（46.2-689.3 cm3）.The fraction size of radiotherapy was 2.0-2.5 Gy/f,1f/d,5 f/w,the time range 4 to 7 w complete treatment,the median dose was 55.2 Gy（range 33-70 Gy）.The IMRT was all five fields.Results All the patients underwent completed treatment.Median follow-up was 8.2 months（range 4-21months）,one year survival rate was 65.4%.The outcomes for 3 months after completion of IMRT： 1 patient（3.8%） with CR;19 patients（73.1%） with PR;3 patients（11.5%） with SD;3 patients（11.5%） with PD.The main toxicities were radiation pneumonia and radiation esophagitis.Conclusion The five fields IMRT were feasible and available for NSCLC.The radiation toxicity was acceptable.