大分割放疗在局部晚期或晚期非小细胞肺癌中的疗效

Clinical efficacy of hypofractionated radiotherapy for patients with locally advanced or advanced non-small cell lung cancer

目的探讨难以行常规分割放疗的局部晚期/晚期非小细胞肺癌(NSCLC)患者,45 Gy分15次大分割放疗的近期疗效和不良反应。方法回顾性分析2014—2018年间天津医科大学肿瘤医院64例无法手术的局部晚期/晚期NSCLC患者。使用Pinnacle 9计划系统设计计划,并采用调强放疗或容积旋转调强放疗行胸部大分割放疗(45 Gy分15次)。探讨其近期疗效、生存率和不良反应。结果中位随访时间为26个月。在可评价的58例患者中2例(3%)完全缓解,22例(38%)部分缓解,28例(44%)疾病稳定,6例(9%)疾病进展,局部控制率为90%。中位复发时间、总生存期分别为8.2、21.0个月,1、2、3年复发率分别为37%、28%、14%,总生存率分别为66%、43%、27%。放疗期间11例(17%)急性食管炎,12例(19%)急性肺炎,13例(20%)骨髓抑制,未发现≥3级食管炎和肺炎。结论45 Gy分15次大分割放疗在局部晚期/晚期NSCLC中安全有效,不良反应可控。

Objective To evaluate the survival outcome and toxicity of hypofractionated radiotherapy(45 Gy/15f)in patients with locally advanced/advanced non-small cell lung cancer(NSCLC)who are ineligible for conventional fractionated radiotherapy.Methods The early efficacy,survival and toxicity of inoperable patients(n=64)with locally advanced/advanced NSCLC patients admitted to Cancer Hospital of Tianjin Medical University from 2014 to 2018 were retrospectively analyzed.Hypofractionated radiotherapy(45 Gy/15f)were performed by using intensity-modulated radiotherapy or volumetric-modulated arc therapy technologies on Pinnacle 9 planning system.Results The median follow-up time was 26 months.The early efficacy was available in 58 patients:complete response for 2 cases(3%),partial response for 22(38%),stable disease for 28(44%)and progressive disease for 6(9%),respectively.The local control rate was 90%.The median time to progression(TTP)and the median overall survival(OS)for all patients was 8.2 months and 21.0 months,respectively.The 1-,2-and 3-year TTP rate was 37%,28%,14%and the OS rate was 66%,43%and 27%,respectively.The incidence of esophagitis was 17%(n=11),19%(n=12)for radiation pneumonitis and 20%(n=13)for myelosuppression.No grade≥3 esophagitis or pneumonia was found.Conclusion Hypofractionated radiotherapy(45 Gy/15f)is efficacious and safe for patients with locally advanced/advanced NSCLC,which yields controllable adverse events.