两种适形放疗技术在肺癌脑转移瘤中的疗效对比

Comparative Analysis of Two Methods for 3D-CRT with Brain Metastases of Non-small Cell Lung Cancer

目的分析采用三维适形同步增量照射（SIB—CRT）与适形序贯增量（SB—CRT）在脑转移瘤治疗中的疗效。方法选择2010年4月至2012年4月本院56例非小细胞肺癌脑转移患者。同步组29例患者采用全脑放疗PTV 36Gy／20f同步转移灶适形放疗PGTV 15Gy／10f，序贯组27例患者采用先给予全脑放疗PTV 40Gy／20f后，缩野至转移灶PGTV 20Gy／10f。通过对近远期疗效，不良反应的观察对比，分析其疗效。结果随访到52例患者，4例失访，随访期3～48个月。同步组肿瘤控制率81．4％，中位生仔期为12．3个月，KPS评分3个月80分以上占55．5％，序贯组肿瘤控制率76％，中位生存期为10．4个月，KPS评分3个月80分以上占40％。结论三维适形同步增量照射较适形序贯增造更为有效，能提高患者的生存质量，减少放射损伤，延长生存时间。

Objective To assess the clinical efficacy of the SIB - CRT and SB - CRT with brain metastases of nnn - small cell lung caneer. Methods 56 cased of patients with brain metastases of non - small cell lung eancer were selected in our hospital from April 2010 to April 2012. 29 cases were treated in whole brain PTV was 36Gy/20f, synchronous the metastasis PGTV was 15 Gy/10 f in SIB - CRT plan. 27 cases were treated in whole brain PTV was 40 Gy/20 f,then the metastasis PGTV was an extra boost 20Gy/10f. Curative el＇feet was compared between two groups, adverse reactions were also reeorded. Results 52 cases of patients were followed -up 3 -48 months,4 cases were lost. The overall local tumor control rate was 81.4% by SIB- CRT, the median survival was 12.3 months. Karnofsky Performance Scale （KPS） score 〉 80 was 55. 5% in 3 months. The overall local tumor control rate was 76% by SB -CRT, the median survival was 10.4 months. KPS score 〉 80 was 40.0% in 3 months. Conclusion Rather than SB - CRT, the SIB - CRT may more improve life quality of patients with brain metastases of non - small cell lung eancer, reduce radiation damage, and prolong patients＇ survival time.