立体定向放射治疗非小细胞肺癌的临床分析

背景与目的：立体定向放射治疗能提高肿瘤的局控率，降低正常组织反应。目前，越来越多地应用于临床。本研究观察立体定向放射治疗非小细胞肺癌的疗效及副反应：方法：对40例不能手术的非小细胞肺癌患者进行放射治疗，对纵隔淋巴结阳性的患者，先常规外照射30～40Gy，然后对肿瘤局部用立体定向放疗追加照射剂量，每次2．5～4．85Cy，照射10～12次；对无纵隔淋巴结转移且肿瘤直径小于6cm的患者单用立体定向放射治疗，单次剂量3～8Gy，每日一次，共照射5～18次。结果：40例患者均顺利完成治疗，近期疗效为完全缓解（CR）11例，部分缓解（PR）24例，总有效率（CR＋PR）为87．5％（33／40），1、2年生存率分别为85．4％和45．1％，放疗期间无急性放射性肺炎发生。肿块较大及年龄大于70岁为影响生存率的危险因素。结论：立体定向放射治疗对非小细胞肺癌有良好的治疗效果，并发症较低，大部分患者能够耐受。

Clinical analysis of stereotactic radiotherapy for primary non-small-cell lung cancer

Background and purpose:Stereotactic radiotherapy(SRT) is widely used in clinical treatment because it provides a method increasing local tumor control while minimizing tissue toxicity.In this study,we observed the efficiency and side-effects of patients with primary non-small-cell lung cancer(NSCLC)treated by stereotactic radiotherapy(SRT) for primary non-small-cell lung cancer(NSCLC).Methods:Forty patients with inoperable NSCLC were treated by radiotherapy.Patients with positive lymphnodes received conventional fractionated radiotherapy to a total does of 30-40 Gy,followed by SRT with single dose at 2.5-4.85 Gy in 10-12 fractions.Patients with negative lymphodes and whose diameter of tumor small than 6 cm were treated with SRT.We delivered at a dose of 3-8 Gy once per day,in 5-18 fractions.Results:All 40 patients completed their radiotherapy.The overall immediate response rate(CR+PR) was 87.5%(35/40),Survival rates at 1 and 2 years were 85.4% and 45.1%,respectively.There was no acute radiation pneumonitis.Mutivariate analysis revealed that tumor size and age were the independent and statistically significant factors affecting the patient's survival(P<0.05).Conclusions:SRT can be considered as an effective and feasible approach to treat NSCLC with good responses and without any early serious complications.