全身伽玛刀联合多西他赛治疗老年晚期非小细胞肺癌疗效观察

Clinical analysis of whole body gamma knife combined with docetaxel on aged patients with advanced non-small cell lung cancer

目的：探讨全身伽玛刀放疗联合多西他赛单药化疗治疗老年晚期非小细胞肺癌的临床疗效及副作用。方法：38例老年非小细胞肺癌患者均采用全身伽玛刀放疗，总量35～50Gy ，分10～14次完成，1次/d ，每周5次；伽玛刀治疗结束后1～2周开始化疗，采用多西他赛75mg/m2，静滴d1，28d为1周期，每位患者至少化疗2周期。结果：38例患者近期有效率为71．05％（27/38），76．32％（29/38）的患者治疗后KPS评分提高。1年生存率54．9％，2年生存率30．3％，中位生存期14．0个月。放射性肺炎发生率15．79％（6/38），放射性食管炎发生率10．53％（4/38），白细胞下降发生率42．10％（16/38），多为1～2级。结论：全身伽玛刀联合多西他赛化疗是一种治疗老年晚期非小细胞肺癌可行、有效的方法。

Objective ：To observe the curative effects of whole body Shortterm gamma knife combined with concurrent chemotherapy for treatment on aged patients with advanced non-small cell lung cancer （NSCLC） . Methods ：A total of 38 elderly advanced NSCLC patients were treated with whole body gamma knife combined with concurrent chemotherapy .Radiation was delivered in 10 to 14 fractions with a cumulated marginal dose ranged 35 to 50 Gy .Chemotherapy with docetaxel （75mg/m2 d1） was given after whole body gamma knife ,28d per cycle .At least 2 cycles were delivered .Clinical effects were evaluated 3 months after whole bodygamma knife treatment .Re-sults ：The total efficacy rate was 71 .05% （27/38） .The Kamofsky score of patients improved rate was 76 .32% （29/38） .The 1-year survival rate and 2-year survival rate were 54 .9% and 30 .3% ,respectively .Median survival dura-tion was 14 .0 months .Acute radiation induced lung injury was 15 .79% （6/38） ,acute radiation induced esophagus injury was 10 .53% （4/38） ,leucopenia was 42 .10% ,mainly grade 1-2 .Conclusion ：Whole body gamma knife com-bined with docetaxel is a feasible ,safe and effective method for elderly advanced NSCLC patients .