大分割三维适形放射治疗在肺部转移瘤中的应用

目的探讨大分割三维适型放射治疗转移瘤的方法和疗效。方法采用CT定位，CMS治疗计划系统三维适型大分割放射治疗肺转移瘤45例，共计66个病灶，病灶大小0．5～5．0cm，〈3．0cm47个，3．0-5．0cm19个。辐射源为6MVX线，单次照射剂量5GY，隔日照射，总剂量50GW10F。结果肿瘤消失11灶（28．9％），转移灶缩小（PR）的有38灶（62.2％），总有效率74．2％，病灶〈3cm者有效率为82．97％，明显高于肿瘤≥3cm者（P〈0．01）。全组患者1，2，3年生存率分别为55．6％（25／45），35．6％（16／45），17．8％（8／45）。结论大分割三维适型放射治疗是治疗肺转移瘤的有效方法，其近期疗效与转移灶大小有关。

The Apply of 3D-CRT with Hypofractionated High-dose in the Treatment of Lung Metastases

Objective To explore the methodsand effects of 3D-CRT with hypofractionated high-dose in the treatment of lung metastases. Methods from Jul.2008 to Nov.2011,45 cases with lung metastases were treated by 3D-CRT with hypofractionated high-dose in our hospital. The total number of the metastases were 66.The diameter of the metastases was 0.5-5.0cm.less than 3.0cm in 47,3.0-5.0cm in 19.6MV.X-ray was chosen as radiationsource. The dose per fraction was 5GY, and the total prescribed dose was 50GY at the margin of the PTV enveloped by 95% insodose curve. Result Local regression of the metastases were evaluated by CT image obtained in 3 months after treatment. Complete regression was found in 11 foci（28.9%）, partial regression in 38 foci（62.2%）, and the overall effective rate was 74.2.The effective rate for the loci with diameter less than 3 cm was 82.97%,and 52.6% equal or more than 3cm,there was significantly different（P〈0.01）.Conelusion The measure was an effective treatment method, for patients with Lung metratases.