三维适形放疗不同剂量分割治疗晚期非小细胞肺癌疗效观察

目的 探讨三维适形放射不同剂量分割治疗晚期非小细胞肺癌( NSCLC)的近期疗效.方法 148例NSCLC随机采用三维适形放疗(3DCRT)(观察组,75例)和常规分割照射治疗(对照组,73例),观察近期疗效和不良反应,随访患者治疗后1、2、3年生存情况.结果 对照组总有效47例(64.4％),观察组总有效60例(80.0％),两组差异有统计学意义(x2=4.50,P＜0.05).对照组1、2、3年生存率为50.7％、24.7％、8.2％,中位生存期为13个月；观察组分别为73.3％、45.3％、20.0％,中位生存期为19个月.两组生存率差异有统计学意义(x2=8.07、6,94、4.22,均P＜0.05).观察组血液系统副反应发生率明显低于对照组(x2=4.73,P＜0.05),两组急性放射性肺炎、放射性食管炎发生率差异无统计学意义(P＞0.05).结论 3 DC RT对晚期NSCLC近期疗效好,且治疗不良反应低,值得在临床上推广应用.

Observation of the effect of three-dimensional conformal radiation dose fractionation treatment of advanced non-small cell lung cancer

Objective To explore the effect of three-dimensional conformal radiation dose fractionation treat- ment of advanced non-smal! cell lung cancer（NSCLC）. Methods 75 NSCLC patients were treated with hypofraction- ated 3DCRT（ observation group ）, while 73 cases were treated with conventional fractionated radiotherapy （control group）. The efficacy and adverse reactions were observed ; Survival after treatment were followed up in 1,2,3 years. Lung function was detected before and after radiotherapy treatment, including FVC, FEV1 and CLCO. Results The total effective cases of control group were 47 cases patients （64.4%） , observation group＇s was 60 cases （80.0%）, to- tal effective rate had statistically significant difference（ X2 = 4. 50 ,P 〈 0. 05 ）. Survival of control group aiter treatment in 1,2,3year were 50.7% ,24.7% , 8.2% , the median survival was 13 months, observation group＇s were 73.3% , 45.3 % , 20.0% , and 19 months. The survival of these two groups was statistically different （ X2 = 8.07,6.94,4.22, all P 〈 0.05 ）. The patients blood system side effects of observation group were significantly lower than the control group （X2 = 4. 73, P 〈 0.05 ） ;acute radiation pneumonia, esophagitis of these two groups had no significant difference in the incidence（ P 〉 0.05 ）. Conclusion Hypofractionated 3DCRT treatment of advanced NSCLC had good e.ffect, and its adverse reactions was low, and it was worthy of clinical application.