伽玛射线立体定向放疗治疗老年早期非小细胞肺癌的临床评价

Clinical assessment of γ-beam stereotactic radiotherapy for elderly patients with early stage non-small cell lung cancer

【目的】观察体部伽玛射线立体定向放疗(stereotactic body radiotherapy,SBRT)治疗老年早期非小细胞肺癌(non-smallcell lung cancer,NSCLC)的疗效及安全性。【方法】37例老年早期NSCLC患者(T1a^b 23例、T2a 14例)接受伽玛射线立体定向放疗治疗。50%等剂量曲线覆盖100%计划靶区体积,70%~75%剂量线覆盖95%以上肿瘤靶区体积。处方剂量为5.0~6.0Gy/次,3次/周,共10~12次,总剂量50~600 Gy。【结果】所有患者顺利完成伽玛射线体部SBRT,耐受性良好,未发生III级以上的不良反应。37例患者完全缓解率72.97%(27/37),部分缓解率21.62%(8/37),稳定2.70%(2/37)。有效率为94.59%,局部控制率94.59%(35/37),临床获益率为100%。1、2、3年无进展生存率分别为83.8%、78.4%和67.6%。1、2、3年总生存率分别为91.9%,81.1%和73.0%。【结论】伽玛射线体部立体定向放射治疗老年早期非小细胞肺癌疗效显著,副作用轻微,耐受性良好。

[Objective ]To evaluate the efficacy and toxicity of γ-beam stereotactic body radiotherapy （SBRT）for elderly patients with early stage non-small cell lung cancer （NSCLC）. [Methods] 37 elderly patients with early stage NSCLC （23 Tla -b, 14T 2a） were treated with SBRT, covering 100% planning target section with 50% isodose curve and covering 95% tumor target section with 70% 75% isodose curve. Every prescribed dose is 5.0 - 6.0 Gy （3 times per week, a total of 10 - 12 times, total dose 50 - 600 Gy）. [ Results ] Complete remission （CR） was achieved in 27 of the 37 patients （72.97%）, partial remission （PR） was achieved in 8 of the 37 patients （21.62%） and stable （SD） was achieved in2 of the 37 patients （2.7%）. The total effective rate was 94.59%, disease control rate （DCR） waslO0%. The 1st, 2nd, and 3rd year progression-free survival rate were 83.8%, 78.4% and 67.6%, respectively. The 1st, 2nd, and 3rd year overall survival rates were91.9% （34/37）, 81.1% （30/37） and 73.0% （27/37）, respectively. [ Conclusion ] With minimal toxicity and good tolerance, SBRT can provide excellent rate in treating elderly patients with early stage non-small cell hmg cancer.