三维适形放射治疗肺癌脑转移临床疗效观察

目的：通过观察脑转移三维适形放射治疗的结果，探讨三维适形放射治疗对非小细胞肺癌脑转移的临床意义。方法：1998年5月-2006年2月41例确诊肺癌脑转移患者，其中合并颅外转移18例，非颅外转移23例。所有患者首先经全脑放疗，2—3Gy／次，5次／周，DT30Gy-40Gy，然后行三维适形放射治疗局部加量，90％的等剂量曲线包括靶区，DT4—6Gy／次，总剂量12Gy-24Gy。结果：治疗有效率90．2％（37／41），中位生存期18月，半年生存率79．9％，1年生存率66．7％。结论：全脑放射治疗＋三维适形放射治疗可以提高脑转移的靶区剂量，并提高局部控制率，减少脑部复发的机会，同时颅外转移灶及原发灶的治疗也非常重要。

Clinical observation of three dimensional conformal radiotherapy in lung cancer with brain metastasis

Objective:Through the observation of result of conformal radiotherapy, to explore the clinical significance of three dimensional conformal radiotherapy to treat the brain metastasis of non-small cell lung cancer. Methods: Amomg 41 patients of lung cancer with brain metastasis 18 were combined with extra cranial metastasis, and the other 23 cases without extra cranial metastasis. All patients were treated by whole brain irradiation therapy(WBRT) 2-3Gy for 5 times/week, and the total dosage was 30Gy-40Gy, then treated by conformal radiotherapy. The 90% equi-dosage line include the target area: Fraction dosage was 4-6Gy/time and 5 times week according the size of target area , and the accumulative radiotherapy dosage was 12Gy-24Gy. Results: The effective rate was 90.2%(37/41), the media survival time was 18 months,the half one year survival rate was 79.9%, 1-year survival rate was 66.7%. Conclusion: Three dimensional conformal radiotherapy can increase the dosage of metastasis focus,and have significant effect of improving local control rate of three dimension conformal radiotherapy to treat brain metastasis.