超分割放射治疗局部晚期非小细胞肺癌的临床研究

目的探讨超分割放疗在晚期非小细胞肺癌治疗中的作用。方法超分割组：１２Ｇｙ／次,每日２次,间隔至少６ｈ,Ｄｒ７２Ｇｙ／６ｗ。常规组：２Ｇｙ／次,每天１次,Ｄｒ６４Ｇｙ／６４ｗ共３２次。两组均５ｄ／ｗ。结果超分割组和常规组总有效率分别为６４０％（１８／２８）和５７１％（１６／２８）,无显著性差异（Ｐ＞００５）。随访３年,超分割组和常规组的一年、二年和三年生存率及局部控制率分别为６７９％、３２１％、２１４％和６４３％、４２９％、２８６％;４６４％、１７９％、１０７％和４２９％、２５０％、１７９％;均有显著性差异（Ｐ＜００５）。两组放射性食管炎和肺炎的发生率分别为５３６％、７１％和３２１％、１７９％,无显著性差异（Ｐ＞００５）。结论超分割放射治疗局部晚期非小细胞肺癌,反应轻微,患者均可耐受;并有提高肿瘤局部控制率和改善长期生存率的作用,疗效优于单纯常规放疗。

CLINICAL STUDY OF HYPERFRACTIONATED IRRADIATION IN THE TREATMENT OF LOCALLY ADVANCED NON SMALL CELL LUNG CANCER (NSCLC)

PURPOSE In order to evaluate the effect of hyperfractionated radiotherapy (HFI) and conventionally fractionated irradiation (CFI) for advanced NSCLC. METHODS The patients were irradiated by 1 2 Gy per fraction, twice daily with an interval of more than 6 hrs to a total does of 72Gy/60Fx/6w in HFI group. The patients or the CFI group were given a daily fraction of 2Gy, 5 times a week to a total dose of 64Gy/32Fx/6 4w.RESULTS The overall response rate in the HFI group and the CFI group were 64 0% (18/28) and 57 1% (16/28) respectively. The difference was not significant ( P >0 05). All of the patients were followed three years or more. The 1 , 2 , 3 year survival rates and local control rates respectively 67 9%, 32 1%, 21 4% and 64 3%, 42 9%, 28 6% in FHI group and were 46 4%, 17 9%, 10 7% and 42 9%, 25 0%, 17 9% in CFI group ( P <0 05). The incidences of esophagitis and pneumonitis in HFI group were 53 6% and 7 1%, and in CFI group they were 32 1% and 17 9% ( P >0 05).CONCLUSION The treatment results in HFI group were better than that in CFI gruop. HFI can improve 1 3 year survival rates and local control rates with minimal irradiation reactions, especially radiation pneumonitis.