X刀立体定向放射治疗非小细胞肺癌的临床研究

目的观察X刀立体定向放射治疗非小细胞肺癌(NSCLC)的近期、远期疗效及其并发症,探讨X刀立体定向放疗在非小细胞肺癌治疗中的应用价值。方法75例符合条件的NSCLC患者随机分为两组,X刀治疗组38例,应用X刀立体定向放疗,剂量4~6Gy/次,每日或隔日1次,共治疗8~10次,使GTV边缘剂量达45~55Gy。常规放疗组37例,常规分割放疗,每次1.8~2.0Gy,每日1次,每周5次,总照射剂量60~65Gy。结果X刀组总有效率(CR PR)为86.8%,明显优于常规放疗组的62.1%,两组差异有非常显著性(P<0.05)。X刀组1,2,3年生存率分别为87.5%、60.0%和35.0%;常规放疗组分别为58.3%、27.8%和16.7%,两组间1,2,3年生存率比较差异均有显著性。结论与常规放疗相比,X刀立体定向放疗可以在较好保护周围正常组织的同时,提高肿瘤照射区的放射剂量,从而增加非小细胞肺癌的局部控制率,提高远期生存率。

Clinical study on treatment of non-small cell lung cancer with X-knife stereotactic radiotherapy

Objective To evaluate the efficacy and complication of X-knife stereotactic radiotherapy in treating the non-small cell lung cancer and explore the value of X-knife stereotactic radiotherapy in the treatment of non-small cell lung cancer.Methods Seventy-five patients with non-small cell lung cancer were divided into two groups randomly:(1)X-knife group:38patients,3-4 Gy five times weekly,with a total dose of 50-55 Gy;(2)Conventional radiotherapy group:31patients,1.8-2Gy once daily,with a total dose of 60-65 Gy.The tumor regression and acute radiation toxicity were assessed.Results (1)The overall response rate(CR PR)in X-knife group was 86.8%,while that in conventional radiotherapy group was 62.1%,with statistically significant difference(P<0.05).(2)The 1-,2- and 3-year survival rates were 87.5%,60.0% and 35.0% in X-knife group and 58.3%,27.8% and 16.7% in conventional radiotherapy group.The differences between the two groups were statistically significant.Conclusion Compared with conventional radiotherapy,X-knife stereotactic radiotherapy can achieve tumor dose escalation,and give the normal tissue better protection at the same time.It can improve the tumor control rate of non-small cell lung cancer,and so can improve long survival rate.