加速超分割放疗非小细胞肺癌的毒性反应

The Toxic Reaction of Hyperfraction Accelerated Radiotherapy for Non-small Cell Lung Cancer

了解非小细胞肺癌 (NSCIC)加速超分割放疗的毒性反应。材料与方法 1991年 12月～ 1996年 12月将 12 5例非小细胞肺癌患者随机分成加速超分割放疗 (HART)和常规放疗 (CF)两组。其中HART组 65例 :3次 /天 ,1 1Gy/次 ,间隔 4小时 ,5天 /周 ,总剂量 72 6～ 75 9Gy/ 66～ 69次 ,共 3 3 (2 9～ 42 )天 ;CF组 60例 :1次 /天 ,1 8～ 2 0Gy/次 ,5天 /周 ,总剂量 63 6～ 71 6Gy/ 3 3～ 3 8次 ,共 48(45～ 5 2 )天。结果 ①急性放射性食管炎HART组为 86% ,明显大于CF组 42 % (P <0 0 0 1) ,且出现时间早、持续时间长 ;②两组急性放射性肺炎及肺纤维化均无差异。结论 ①HART急性放射性食管炎的反应大于CF ,但不增大放射性肺炎及肺纤维化反应 ;

Objective To evaluate the tolerance and toxic reaction of hyperfraction accelerated radiotherapy for non-small cell lung cancer (NSCLC).Methods 125 patients with NSCLC were treated from December 1991 to December 1996.They were randomized into two groups:hyperfraction accelerated radiotherapy (HART) group and conventional fractionation radiotherapy(CF) group.65 patients in HART received 1.1 Gy per fraction, three fractions per day with on interval of 4 hours and 5-day treatment per week. The total doses were 72.6～75.9Gy/66～69Fx,33(29～42)days.60 patients in CF received 1.8 Gy to 2.0 Gy per fraction, five fractions per week with the total doses of 63.6～71.6 Gy/33～38 Fx,48(45～52) days.Results Acute and late complications:① There was significant difference in the incidence of acute radiation esophagitis between groups HART (86%) and CF (42%) ( P <0 001).The symptom in the HART group occurred earlier and lasted longer.② There was no difference between acute pneumonitis and radiation lung fibrosis in both groups.Conclusions ①HART can be tolerated by most NSCLC patients.②HART increased the incidence of acute esophagitis rather than the radiation pneumonitis or lung fiberosis.