立体定向放疗序贯TP方案治疗不能手术的早期非小细胞肺癌临床研究

目的研究立体定向放射治疗序贯TP方案化疗治疗不能手术的早期非小细胞肺癌疗效和毒副作用。方法60例不能手术的早期非小细胞肺癌患者随机分成A组和B组进行临床研究，A组30例采用立体定向放射治疗，剂量（50％剂量线）4～5Gy／次．隔日1次，共8～10次，总剂量40～50Gy。B组30例采用立体定向放射治疗序贯TP方案化疗四个疗程。结果两组患者的总有效率分别为80．O％（24／30）和83．3％（25／30），P〉0．05，患者1、2年总生存率分别为86．7％（26／30）VS83．3％（25／30）和73．3％（22／30）VS80．0％（24／30），P〉0．05。2年无远处转移生存率分别为60．0％（18／30）和73．2％（22／30），B组虽高于A组，但P〉0．05。两组患者早期放射反应主要为I～II级放射性肺炎和骨髓抑制，后期放射反应主要为I～II级放射性肺炎，发生率两组接近。结论立体定向放射治疗序贯TP方案化疗治疗不能手术的早期非小细胞肺癌疗效较好。

Clinical Study on Stereotactic Radiotherapy Ssequence TP for Inoperable Early Stage Non-small-cell Lung Cancer

Objective To evaluate the therapeutic efficacy and the radiation complication of stereotactic radiotherapy sequence TP in patients with inoperable early stage non-small-cell lung cancer （NSCLC）. Methods 60 patients with inoperable early stage NSCLC were randomly divided into two groups. The 30 patients in group A received stereotactie radiotherapy. Dosage（50%） to the total dose of 40 - 50 Gy with 4 - 5 Gy per fraction treated every other day, 8 - 10 times. The 30 patents in group B received stereotactic radiotherapy sequence TP 4 cycles. Results The efficacy rates in group A and B were 80.0% and 83.3%, without significant difference （p 〉0.05）. The one and two year survival rates of the patients in group A and B were 86.7% （26/30） VS 83.3% （25/30）, 73.3% （22/30） VS 80.0% （24/30） respectively, without significant difference （p 〉0.05）. The two year non-metastasis survival rates were 60.0% （18/30） and 73.2% （22/30） respectively, the group B was better than group A, but without significant difference （p 〉0.05）. The major acute radiation complication observed in the two groups were grade I to II radiation pneumonitis and hematopoietic toxicity. The later radiation complication in the two groups were grade I to II radiation lung fibrosis, without significam difference. Conclusion The efficacy of stereotactic radiotherapy sequence TP is better than stereotactic radiotherapy in patients with inoperable early stage NSCLC.