γ射线立体定向放射治疗非小细胞肺癌老年病人的临床疗效分析

THE CLINICAL EFFICACY OFγ-RAY STEREOTACTIC RADIATION THERAPY NON-SMALL CELL LUNG CANCER IN ELDERLY PATIENTS

目的：研究酌射线立体定向放射治疗对非小细胞肺癌老年病人的临床疗效。方法：回顾性分析我科2009-03~2011-03内62例进行酌射线立体定向放射治疗的非小细胞肺癌老年病人的疗效,全部62例病人均经病理证实为非小细胞肺癌,酌射线立体定向放射治疗的方法为利用50%~70%等剂量线包绕计划靶区,单次剂量为400-500 cGy/次,5次/wk,共计10~12次,肿瘤边缘总剂量达40~60 Gy,Kaplan Meier法计算局部控制率和生存率。结果：62例病人全部完成治疗,中位随访期为22mo,随访率为100%,治疗结束后3mo评价近期疗效：完全缓解率（CR）为19%（12/62）,部分缓解率（PR）为71%（44/62）,稳定（NC）为8%（5/62）,进展（PD）为2%（1/62）,总有效率（CR＋ PR）为90%；治疗结束后1a局控率为98%,总生存率为100%；治疗结束后2a局控率为89%,总生存率为92%。早期肺放射反应I级6例,II级2例；晚期肺损伤II级反应5例。结论：对于老年非小细胞肺癌病人,采用酌射线立体定向放射治疗能够较好的控制肿瘤的局部进展,缓解症状,且副作用低。

To investigate γ-ray stereotactic radiation therapy on the clinical efficacy of non-small cell lung cancer in elderly patients. Methods：A retrospective analysis of the efficacy of γ-ray stereotactic radiotherapy for 62 elderly patients with non-small cell lung cancer,which were treated in our department from March 2009 to March 2011 62 patients were pathologically confirmed non-small cell lung cancer,γ-ray stereotactic radiotherapy for 50% ~70% isodose curve planning target volume, a single dose of 400 cGy/5 times/week,for a total of 10~12 times the edge of the tumor total dose of 40~60 Gy, Kaplan Meier method to calculate the local control rate and survival rate. Results：62 patients completed treatment,the median follow-up period of 22 months,follow-up rate was 100%,3 months after the end of treatment evaluation short-term effect：complete remission（ CR） rate was 19%（12/62）,some response rate（PR）was 71%（44/62）,stable（NC）to 8%（5/62）,progress（PD）to 2%（1/62）,the total response rate（CR ＋PR）to 90%;after the end of treatment,1-year local control rate was 98%, the overall survival rate was 100%;2-year local control rate was 89%after the end of treatment,the overall survival rate was 92%. Early lung radiation reaction Class I, II 2;5 cases of advanced lung damage Class II response;Conclusion：For elderly patients with non-small cell lung cancer,the use ofγ-ray stereotactic radiotherapy can control locally advanced tumor,relieve symptoms and side effects is low.