肺癌放疗后复发患者应用适形放疗的疗效观察

Clinical research of conformal radiotherapy for lung cancer recurrence after radiotherapy

目的观察肺癌放疗后复发患者应用适形放疗的治疗效果。方法选择肺癌放疗后复发患者60例，随机分为观察组和对照组各30例，观察组采用适形放射治疗，对照组采用常规放射治疗。两组放疗照射总剂量均为60-70Gy，1次／d，5次／w，连续5—7w。两组均使用化疗配合放疗治疗，紫杉醇30mg＋顺铂30mg，1次／w，连续5—7w，化疗于放疗第1天开始。通过临床观察及治疗后连续2年随访，比较两组治疗效果及毒性反应情况。结果观察组完全缓解17例，部分缓解9例，无变化2例，疾病进展2例，总有效率86．67％；对照组完全缓解10例，部分缓解6例，无变化6例，疾病进展8例，总有效率53．33％，组间总有效率比较，差异有统计学意义（P〈0．05），提示观察组近期效果优于对照组。观察组1年生存病例20例（66．67％），对照组1年生存病例16例（53．33％）；观察组2年生存病例16例（53．33％），对照组2年生存病例10例（33．33o．4），两组间差异有统计学意义（P〈0．05），提示观察组远期效果优于对照组。两组患者均完成全部治疗，其各时期放射反应差异无统计学意义（P〉0．05）。结论肺癌放疗后复发患者应用适形放疗能提高近期治疗效果，延长患者的生存期，毒性反应与常规放疗相同，可在临床推广应用。

Objective To study and probe the treatment effect of conformal radiotherapy in lung cancer recurrence Methods 60 cases of lung cancer patients recurrence were randomly divided into two groups. 30 cases in observation group were treated with conformal radiation therapy. 30 cases in the control group were treated with conventional radia- tion therapy. The radiation total dose of two groups were 60-70Gy, 1 /d, 5 /w, successive 5-7w. The chemotherapy combined with radiotherapy in treatment of paclitaxel and cisplatin, 30mg＋ 30mg, 1/w, 5-7w continuous chemotherapy to radiotherapy, the 1D start. Through the clinical observation and treatment after 2 consecutive years of follow-up, the treatment effect and toxicity of two group were compared. Results In the observation group, 17 cases were complete re- mission, partial remission in 9 cases, no change in 2 cases, the progression of the disease in 2 cases, the total effective rate was 86.67~ the control group complete remission in 10 cases, partial remission in 6 cases, ao change in 6 cases, the progression of the disease in 8 cases, the total effective rate was 53.33~,%. The recent effect of observation group were better than control group, the total treatment efficiency of two groups had significant differences （P〈0. 05）. In observa- tion group, 20 cases 1 years, the survival rate was 66.67~, 16 cases were survival in 1 years, the survival rate was ~3.33~. In observation group, 16 cases were survival in 2 years , the survival rate was 53.33%. In control group, 10 ：ases were survival in 2 year , the survival rate were 33.33%, The long term effect of observation group was better than he control group. The 1 year survival rate, 2 years survival rate between two groups were statistically different （p〈 .05）. Two groups of patients had complete treatment, the response of radiation period without significant difference （p 〉0. 05）. Conclusion The conformal radiotherapy improves the therapeutic effect in lung cancer patients recurrence after adiotherapy , prolong the survival time of the patients, toxic reaction with the same of conventional radiotherapy, it is forth in clinical popularization.