三维适形放射治疗非小细胞肺癌的疗效分析

Therapeutic Effect Analysis of Three Dimensional Conformal Radiotherapy Non-Small Cell Lung Cancer

目的分析非小细胞肺癌患者的三维适形放射治疗的疗效及影响患者生存率的相关因素。方法回顾性分析我科自2005年4月至2010年5月收治的136例非小细胞肺癌患者,全部接受三维适形放射治疗,通过搜集病例资料及长期随访,用单因素和多因素分析患者生存时间及其影响因素。结果 136例患者施行三维适形放射治疗后的近期疗效观察,完全缓解(CR)14.7%(20/136),部分缓解(PR)60.3%(82/136),稳定(SD)19.9%(27/136),进展(PD)5.1%(7/136),总有效率(CR+PR)75%(102/136)。1、2、3、5年生存率分别为79.4%、45.4%、22.1%、12.5%。副反应:1级放射性食管炎35例,2级放射性食管炎16例,3级以上放射性食管炎0例;1级放射性肺炎20例,2级放射性肺炎9例,3级以上放射性肺炎0例。单因素分析显示性别,年龄,病理,分期,剂量,初治疗效对于患者生存时间的影响有统计学意义。多因素分析显示KPS评分,分期,剂量,初治疗效是影响患者长期生存的独立风险因素。结论三维适形放射治疗对非小细胞肺癌患者是一项安全,有效的治疗方法,毒副反应发生率低,且患者放疗后生存期长。

Objective To analysie the treatment effect of non - small cell lung cancer of three dimensional conformal radiotherapy （ 3D - CRT） and to study the effect of patient survival related factors. Methods Retrospective analysis was mack for 136 eases of non - small cell lung cancer, all accept 3D - CRT, through the case data collection and long - term follow - up, using the single factor and multiple factor analysis survival time and its influencing factors. Results The recent curative effects of 136 cases of patients with three dimensional conformal radiotherapy： Complete response （CR） 14.7% （20/136） , partial response （PR） 60.3（82/136） ,stable disease （SD） 19.9% （27/136） ,progression disease （PD） 5.1% （7/136） ,total effective rate is 75% （102/136）. One ,two ,three ,five year survival rate is 79.4% ,45.4% ,22.1%, 12.5 %. Side effects： Class 1 radiated esophagitis 35 cases, Class 2 radiated esophagitis 16 cases, Class 3 and above radiated esophagitis 0 case. Class I radiated pneumonia 20 cases, Class 2 radiated pneumonia 9 cases, Class 3 radiated pneumonia 0 case. Single factor analysis shows the influence of gender, age, pathology, phase, dose, and first - phase curative effect to the survival time are of a statistical significane, Multiple factor analysis showed KPS score, phase, dose, first -phase curative effect are the survival time independent factors. Conclusion 3D - CRT for patients with non - small cell lung carcinoma is a safe, effective treatment method, Side effects are relatively low , and the patients survival time is long after radiotherapy.