大分割适形放疗在中晚期非小细胞肺癌的疗效观察

目的 评价大分割适形放疗治疗中晚期非小细胞肺癌的疗效及其副作用。方法 80例中晚期非小细胞肺癌随机分为大分割适形放疗组和常规适形放疗组，每组40例。全部采用10Mv的X射线外照射，大分割适形放疗组总剂量60Gy／3周，常规分割适形放疗组总剂量60～68Gy／6～7周。结果1、2、3年局控率大分割适形放疗组明显较常规分割适形放疗组高（65．0％ vs40．0％、50．0％vs27．5％、27．5％vs10．0％，P〈0．05）。1、2、3年生存率大分割适形放疗组明显较常规分割适形放疗组高（80．0％vs60．0％、70．0％vs47．5％、60．0％vs37．5％，P〈0．05）。大分割适形放疗组不良反应发生率与常规适形放疗无明显差异。结论 大分割适形放疗能提高中晚期非小细胞肺癌的治疗效果，不良反应未见明显增加。

Therapeutic effect of high-dose three-dimensional conformal radiotherapy for patients with advanced non-smallcell lung cancer

Objective To evaluate the efficiency of high-dose three-dimensional conformal radiotherapy and the risk of radiation injury in patients with non-small cell lung cancer(NSCLC). Methods 80 patients with histological confirmed carcinoma of the NSCLC were randomized into two groups to patients of high-dose fraction three-dimensional conformal radiotherapy(3D-CRT) were treated with high-dose three-dimensional conformal radiotherapy at the total dose of 60Gy in 15 fractions implemented in a course of 3 weeks,4Gy for each fraction and the other 40 patients underwent conventional fraction three-dimensional conformal radiotherapy at the total dose of 60 to 68Gy in 30 to 34 fractions completed in 6 to 7 weeks. Results The 1,2,3 year of local control in high-dose fraction three-dimensional conformal radiotherapy group were better than the conventional fraction three-dimensional conformal radiotherapy (65.0% vs 40.0% ,50.0% vs 27. 5% ,27. 5% vs 10. 0% , P< 0. 05),and the 1,2,3 year of survival rate in high-dose fraction three-dimensional conformal radiotherapy group were also better than the conventional fraction three-dimensional conformal radiotherapy(80.0% vs 60. 0% , 70. 0% vs 47. 5% ,60. 0% vs 37.5% ,P< 0.05).The side effections of high-dose fraction three-dimensional conformal radiotherapy group were not significant. Conclusion High-dose fraction three-dimensional conformal radiotherapy has better therapeutic effect in advanced NSCLC and no more radiation-induced injure happens.