BAI加非常规分割放射治疗肺腺癌近期疗效观察

OBSERVATION OF SHORT - TERM EFFICACY OF BRONCHIAL APTERY INJECTION CHEMOTHERAPY AND NON - ROUTINE PARTITION RADIATION THERAPY ON LUNG ADENOCARCINOMA

目的:探索支气管动脉灌注化疗(BAI)后,大剂量低分割放射治疗对中晚期肺腺癌患者的近期疗效及其放射副反应。方法:23例Ⅱ、Ⅲ期肺腺癌患者在BAI治疗2-5次后,行放射治疗,剂量DT2.5GY/F,4/W,肿瘤灶总剂量60GY/24F,6W。结果:原发灶完全缓解(CR)2例,占8％;部分缓解(PR)16例,占69％,总有效率78％(CR+PR);无效或进展(Nc+PD)3例,占13％;2例无法评价疗效。23例中放射性皮肤反应Ⅱ度15例,占65％,Ⅲ度3例,占13％;急性放射性食管炎17例,占74％;放射性肺炎8例,占35％;治疗后KPS提高7例,不变8例,下降8例;血液学检查外周血白细胞Ⅰ-Ⅱ度下降15例,占65％;血小板Ⅰ-Ⅱ度下降10例,占43％。结论:BAI加常规放射治疗肺腺癌,有较好的近期疗效,急性副反应患者可耐受。远期疗效及晚期并发症有待进一步随访。

To investigated the short-term efficacy of large dose and low partition radiation therapy on patients with medium - late term lung adenocarcinoma after they were treated by bronchial artery injection chemotherapy ( BAI) . The side effects of this method were also observed. Method: After treated by BAI two to five times, the 23 patients with phase Ⅱ and Ⅲ lung adenocarcinoma received radiation therapy. Radiative dose was 2.5 GY/F, 4 times a week for six weeks. Result: The primary lesion of two cases (8% ) remiled completely, 16 cases (69%) did partly and total effective rate was 78% . Three cases (13%) had no efficacy and the effects of two cases could be evaluated. Ⅱ degree skin reaction occurred in 15(65%) of 23 patients, Ⅲ degree skin reaction in 3 ones (13%), acute radioactive esophagitis in 17 ones(74%), radioactive pneumonia in 8 ones (35%). After therapy Karnofsky scores of 7 cases increased, 8 ones were unchanged and 8 ones decreased. Hematological examination showed that peripheral leucocyte number decreased I to D degree in 15 case (65%), and platelet number decreased I to H degree in 10 case (43%) . Conclusion: The short - term effect of BAI combination non -routine radiation therapy on lung adenocarcinoma is good, and patients can tolerate the acute side effects. The long - term effects and late complication should be further investigated.