局部晚期非小细胞肺癌常规放疗与三维立体放疗疗效比较

目的：通过回顾分析比较未手术的Ⅲ a 期和Ⅲ b 期非小细胞肺癌（NSCLC） 三维立体适形放疗（3DCRT） 与常规二维放射治疗（2DRT）的治疗效果.方法：选择133 例患者进行分析.其中64 例接受三维放疗,69 例接受普通放疗.结果：三维放疗组的1、3、5 年总生存率分别是69.7%、22.7%、10.4%,中位生存时间为18.6 个月,普通常规放疗组分别为57.3%、12.4%、6.6% 和13 个月（P=0.043）.三维放疗组1、3、5 年的肿瘤专项生存率依次为73.8%、29.7% 和15.8%,常规放疗组是60.8%、15.5% 和12.4%（P=0.020）.Cox 多因素回归分析结果表明：三维立体适形放疗较普通放疗显著提高患者总生存率和肿瘤专项生存率.结论：采用三维放射治疗可以改善不能手术的Ⅲ a 期和Ⅲ b 期非小细胞肺癌患者的生存率.

The Effect of Three Dimensional Conformal Radiation Therapy on Locally Advanced Non-small-cell Lung Cancer Compared with the Effect of Conventional Radiation Therapy

Objective：To compare the effect of three dimensional conformal radiation therapy （3DCRT） on stage Ⅲ A and stage Ⅲ B non-small cell lung cancer（NSCLC） Compared with the effect of conventional radiation therapy（2DRT）.Methods：Author retrospectively analyzed 133 cases：64 cases were treated with three-dimensional conformal radiation therapy, 69 with conventional radiation therapy.Results：There were statistically significant differences on overall survival rates（OS）, cancer specific survival （CSS） and local-regional control （LRC）.In the 3DCRT group, 1, 3, 5 year OS were 69.7%, 22.7%, 10.4%.In the 2DRT group, 1, 3, 5 year OS were 57.3%, 12.4%, 6.6%（P=0.043）.Median survival time for patients who received 3DCRT were 18.6 months vs 13 months of 2DRT.1, 3, 5 year CSS were 73.8%, 29.7%, 15.8% in the 3DCRT group and 60.8%, 15.5%, 12.4% in the 2DRT group （P=0.020）.In multivariate analysis, 3DCRT was associated with increased OS.Conclusion：This study demonstrates that three-dimensional conformal radiation therapy improves survival rate in patients with locally advanced non-small-cell lung cancer compared with conventional radiation therapy.