全脑照射联合三维适形放疗治疗非小细胞肺癌脑转移瘤的疗效观察

Observation of Curative Effect of Whole Brain Irradiation Combined with Three-dimensional Conformal Radiotherapy on Non-small Cell Lung Cancer with Brain Metastasis

目的:探讨非小细胞肺癌脑转移瘤采用全脑照射联合三维适形放疗的疗效。方法:对2006年3月-2010年10月笔者所在医院收治的43例非小细胞肺癌脑转移瘤患者的临床资料进行回顾性分析。随机将患者分为两组,对照组单用全脑放疗DT30Gy/10F,观察组在此基础上配合三维适形放疗,将剂量增加至45Gy。结果:全部患者均完成了整个化疗过程,未出现任何明显的不良反应与并发症,观察组明显优于对照组。观察组有效控制率高达91.7%,平均生存期为12个月,1年生存率分别为33.3%(8/24)、26.3%(5/19),2年生存率分别为8.3%(2/24)、5.3%(1/19),治疗失败多为肿瘤复发或全身多处转移。结论:全脑照射联合三维适形放疗(3DCRT)能有效提高患者局部控制率,改善生活质量及一定程度上延长生存期。

Objective ：To discuss and analyze the curative effect of whole brain irradiation combined with three-dimensional conformal radiotherapy on non-small cell lung cancer with brain metastasis.Methods ：Retrospectively analyzed the 43 patients suffered from non-small eel1 lung cancer with brain metastases treated in our hospital from Mar 2006 to Oct 2010.The patients were randomly divided into control group and observation group.The control group was treated only with whole brain radiotherapy （DT 30 Gy/10F）, while the observation group was treated with three-dimensional conformal radiotherapy in addition to whole brain radiotherapy, and the dose for the observation group was increased to 45 Gy.Results ：All patients received a complete radiotherapy, and no significant adverse reactions and complications were found, the results showed that the observation group was better than the control group.The effective control rate of the observation group was up to 91.7%, and the mean survival time of this group was 12 months, the 1-year survival rates of the two groups were 33.3%（8/24） and 26.3%（5/19） respectively, and the 2-year survival rates were 8.3% （2/24） and 5.3%（1/19） respectively, treatment failure was mainly due to tumor recurrence or systemic multiple metastases.Conclusion ：The whole brain irradiation combined with three-dimensional conformal radiotherapy（3D CRT） can effectively improve patients＇ local control rate, improve their quality of life and prolong the survival period to a certain extent.