非小细胞肺癌后程加速超分割放疗疗效观察

The effects of hyperfractionated accelerated radiation therapy in the later stage after conventional radiation for non-small cell lung cancer

目的:通过前瞻性的研究非小细胞肺癌(NSCLC)后程加速超分割放疗的疗效,寻求NSCLC的最佳治疗手段。方法:对1993年1月～1996年7月我院收治的70例NSCLC患者随机分组研究。常规组35例:用^(60)Co或8M_(v-x),5次/W,2Gy/次,总剂量70Gy/35次/7～8W。后程加速超分割组35例:放疗前程为常规分割,2Gy/次,40Gy/20次/4W后改野,5天/W,2次/天,1.8Gy/次,间隔6～8小时,36Gy/20次/2W,总剂量为76Gy/40次/6W。结果:常规组1、2、3年的局部控制率和生存率分别为57.1％、20％、5.71％;60％、17.1％和8.57％。而后程加速超分割组1、2、3年的局部控制率和生存率分别为74.3％、45.7％、28.6％;77.1％、48.6％和28.6％。结论:非小细胞肺癌后程加速超分割放疗可以提高局部控制率和生存率,建议进一步开展大组随机研究。

Objective:To evaluate the better treatment for non- small cell lung cancer(NSCLC) through the fore study of the hyper fractionated accelerated radiation(HART). Mehtods:70 cases of NSCLC were enrolled in our study and divided into 2 groups, 35 cases in each group. One group treated by conventional irradiation(CFI) during all the treatment. They were received tumor doses of 70Gy in 52 days(49~56) at 2Gy per fraction. The other group treated at the earlier stage by CFI and received doses of 40 Gy in 28 days at 2Gy per fraction, then change to HART, they were irritated to 76Gy/40fx/42days, 1. 1Gy/fx. Results:The local control rates and survival rates of 1,2,3 years were 57.1 %, 20%, 5.71% and 60%, 17.1%, 8.57% respectively in conventional group. Respectively the two rates of the HART group were 74. 3%, 45. 7%, 28. 6% and 77. 1%, 48. 6%, 28. 6% respectively. Conclusions: HART in the later stage results in better survival and local control rates in radiation therapy for NSCLC, which suggest that it need to be studied further for the long range response.