三维适形推量放射治疗配合全脑放射治疗对肺癌脑转移的临床实效性初步评价

目的对三维适形推量放射治疗(three-dimensional conformal radiotherapy,3D-CRT)配合全脑放射(whole brain radiotherapy,WBCT)治疗肺癌脑转移(brain metastases,BM)的临床疗效进行观察并探讨。方法选择笔者医院自2010年8月~2013年3月接诊的肺癌BM患者68例,随机将患者分为观察组和对照组,观察组34例在WBCT治疗的基础上联合3D-CRT进行治疗;而对照组34例则仅接受WBCT治疗。治疗3个月后对治疗效果进行评价,统计治疗过程中的急性毒性反应,并随访1年获得患者的半年生存率和1年生存率。结果观察组缓解率为91.2%(31/34),对照组缓解率为70.6%(24/34),差异具有统计学意义(P<0.05);观察组中位生存期(MST)、生存率和1年生存率分别为14.5个月、79.4%(27/34)和61.8%(21/34),对照组为12.3个月、58.8%(20/34)和38.2%(13/34),差异具有统计学意义(P<0.05);观察组和对照组急性毒性不良反应相比,差异无统计学意义(P>0.05)。结论 3D-CRT联合WBCT治疗肺癌BM可以明显缓解患者症状,提高生存时间,且并未明显加剧患者的急性毒性不良反应。

Explore the Effect of Three-dimensional Conformal Radiotherapy Combine with Whole Brain Radiotherapy for Patients with Brain Metastases of Lung Cancer

Objective To observe and explore the effect of three-dimensional conformal radiotherapy(3D-CRT) combine with Whole brain radiotherapy(WBCT) for patients with brain metastases of Lung cancer. Methods Totally 68 patients with brain metastases of Lung cancer in the hospital from August 2010 to March 2013 were selected. Patients were randomly divided into observation group and control group,with 34 cases in each group.Patients in the observation group accepted 3D-CRT combined with WBCT; while the control group only received WBCT. The efficacy was evaluated after 3 months of treatment, and acute toxicity during the treatment was recorded, and patients were followed up for 1 year to get six months and one year survival rate of survival. Results Remission rate in the observation group was 79.4% (27/34), and was 61.8% (21/34) in the control group, and the difference was statistically significant (P<0.05). The median survival time, six months survival rate and 1 year survival rate in the observation group was 14.5 months, 58.8%(20/34) and 38.2% (13/34), and was 12.3 months, 61.8%(21/34)and 23.5%(8/34)in the control group, and the difference was statistically significant (P<0.05). The difference of acute toxicity between observation group and the control group was not statistically significant (P>0.05). Conclusion 3D-CRT combined WBCT therapy of lung cancer patients with brain metastases can significantly alleviate symptoms and improve survival without increasing side effects.