改良三维适形放疗治疗巨块型局部晚期非小细胞肺癌的临床观察 |
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引用本文: | 纪少春,滕以娟,刘荣强. 改良三维适形放疗治疗巨块型局部晚期非小细胞肺癌的临床观察[J]. 肿瘤研究与临床, 2013, 25(1): 25-28 |
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作者姓名: | 纪少春 滕以娟 刘荣强 |
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作者单位: | 1. 黑龙江佳木斯中心医院放疗科2. 福建省南平市第一医院 |
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摘 要: | 目的 探讨改良的三维适形放疗(3D-CRT)计划对巨块型非小细胞肺癌(NSCLC)的靶区剂量的影响,并观察近期及远期疗效和毒副作用。方法 回顾性分析临床确诊为局部晚期NSCLC的81例患者临床资料;肿瘤直径均≥5 cm;鳞状细胞癌52例,腺癌24例,腺鳞癌5例;ⅢA 63例,ⅢB 18例;分为改良前3D-CRT组(简称T1模式组)39例和改良后3D-CRT组(简称T2模式组)42例。T1模式组接受放化疗综合治疗者31例(79.5 %),放疗剂量2 Gy/次,26~30次,总剂量52~60 Gy;T2模式组接受放化疗综合治疗者31例(73.8 %),放疗剂量2 Gy/次,30~35次,总剂量60~70 Gy。结果 T1模式组患者的1、2、3年总生存率分别为56.4 %、33.3 %、28.4 %,1、2、3年局部控制率分别为38.4 %、28.2 %、20.5 %,中位生存期为17个月;T2模式组患者的1、2、3年总生存率分别为61.9 %、35.7 %、28.5 %,1、2、3年局部控制率分别为47.6 %、40.4 %、30.9 %,中位生存期19个月;两组之间局部控制率差异有统计学意义(P<0.05),总生存率及中位生存期差异无统计学意义(P>0.05)。结论 改良后的3D-CRT技术能够提高巨块型局部晚期NSCLC患者的局部控制率及生存质量,患者1年生存率有提高,远期生存率无提高。
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关 键 词: | 癌,非小细胞肺 改良适形放射疗法:治疗结果 |
Clinical observation on improved three-dimensional conformal radiotherapy in the treatment of massive type locally advanced non-small-cell lung cancer |
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Abstract: | Objective To analyze the effection of improved three-dimensional conformal radiotherapy (3D-CRT) to the dose of target area of local advanced non-small-cell lung cancer (NSCLC) and observe the therapeutic efficacy and toxity. Methods 81 patients with local advanced NSCLC were collected and treated. The diameter of tumor exceed 5 cm. 52 patients were squamous carcinoma. 24 patients were adencarcinoma. 5 patients were adenosquamous carcinoma. 63 patients were onstage of ⅢA, 18 patients were ⅢB. The patients were randomized into two groups, the first group was unmodified planning of 3D-CRT group (T1 group, 39 patients ), the second group was modified planning of 3D-CRT group (T2 group, 42 patients). The 31 patients of T1 group (79.5 %) received radiotherapy and chemotherapy. Toties quoties was 2 Gy. The fractions were 26-30. The total dose was 52-60 Gy. The 31 patients of T1 group (73.8 %) received radiotherapy and chemotherapy. Toties quoties was 2 Gy. The fractions were 30-35. The total dose was 60-70 Gy. Results The 1-, 2-, 3- year overall survive rates of T1 group were 56.4 %, 33.3 %, 28.4 %, the 1-, 2-, 3- year local control survive rates were 38.4 %, 28.2 %, 20.5 %, and the median survive time was 17 months. The 1-, 2-, 3- year overall survive rates of T2 group were 61.9 %, 35.7 %, 28.5 %, the 1-, 2-, 3- year local control survive rates were 47.6 %, 40.4 %, 30.9 %, and the median survive time was 19 months. The significant difference was found for the local control survive rates between T1 and T2 group (P < 0.05). No significant difference was found for the overall survive rates and the median survive time between T1 and T2 group (P > 0.05). Conclution Improved 3D-CRT can advance local control survive rate and living quality to local advanced NSCLC. Meanwhile, it also increases survive rate of 1-year, but can not increase long-time survival rate. |
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Keywords: | Carcinoma, non-small-cell lung Improved conformal radiotherapy |
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