适形放疗在III期非小细胞肺癌的临床研究

目的结合临床实践经验,开展适形放疗在III期非小细胞肺癌的临床研究。方法选择2007年1月~2009年12月收治的经病理证实的IIIa或者IIIb期非小细胞肺癌患者73例为研究对象,采用总结回顾分析法,将研究对象的临床资料进行搜集整理,并与经治医师、责任护士共同探讨病例,探讨适形放疗在III期非小细胞肺癌的临床应用价值。结果近期疗效:原发灶总体有效率为93.15%,纵隔转移淋巴结总体有效率为100.00%,腺癌总体有效率为96.77%,鳞癌总体有效率为80.56%。截至2010年12月,73例患者获得完全随访,随访率达到为100%。全组患者1、2年局控率分别为63.01%和41.11%,全组平均生存时间为(18.91±1.12)个月,1、2年生存率分别为75.34%(55/73)和46.57%(34/73)。其中,Ⅲa期平均时间为(25.33±2.12)个月,1、2年生存率为84.63%、64.12%;Ⅲb期中位生存时间(13.39±2.12)个月,1、2年生存率为66.77%、27.37%。主要毒性表现为白细胞下降,总发生率为94.52%(69/73),其中Ⅲ、Ⅳ度白细胞下降为35.62%(26/73),其次为恶心、呕吐,总发生率为32.88%(24/73),多为Ⅰ、Ⅱ级;急性放射反应主要表现为I、II级放射性食管炎、肺炎,其发生率分别为53.42%(39/73)和12.33%(9/73),未见有Ⅲ、Ⅳ级放射性食管炎、肺炎发生。结论三维适形放射治疗联合低密度化疗对III期非小细胞肺癌进行治疗,取得了较好的疗效,且毒副反应可以耐受,值得临床推广应用。

Clinical research of conformal radiotherapy in III non-small cell lung cancer

OBJECTIVE Combined with clinical practice experience,to carry out conformal radiotherapy in III non-small cell lung cancer.METHODS Selected 73 patients for the study who confirmed as IIIa or IIIb non-small cell lung cancer by pathology from January 2007-December 2009.Took summary review analysis to collect and review the clinical data,and the primary physicians and nurses discussed clinical value of conformal radiotherapy in non-small cell lung cancer III.RESULTS The curative effect:the overall effective rate of primary focus was 93.15%,the mediastinal lymph nodes 100.00%,adenocarcinoma 96.77%,squamous cell carcinoma 80.56%.Until December 2010,73 patients were completely followed up.The local control rates of 1,2 years were 63.01% and 41.11%,the average survival time was(18.91 ± 1.12)months,and 1,2-year survival rates were 75.34%(55/73)and 46.57%(34/73).The average time of Ⅲa period was(25.33 ± 2.12)months,and 1,2-year survival rate was 84.63%,64.12%;the average time of Ⅲb period was(13.39 ± 2.12)months,and 1,2-year survival rate was 66.77%,27.37%.The main toxicity actions were decrease of leucocyte(94.52%),followed by nausea,vomiting(32.88%),last were radioactivity esophagitis and pneumonia(53.42%,12.33%).CONCLUSION Three dimensional conformal radiation therapy combined with low-density chemotherapy can treat III non-small cell lung cancer and achieves good effect,and its toxicity can be tolerated,is worthy of clinical application.