70岁以上老年人非小细胞肺癌的放射治疗

目的　了解老年人非小细胞肺癌 ( NSCLC)放射治疗临床特点。　方法　对 1 3 5例完成根治性放疗的老年 NSCLC患者施行常规和非常规分割放疗 ,其中 52例在放疗前或 (和 )放疗后接受中位数 2周期 ( 1～ 9周期 )的化疗。　结果　按时完成放疗者 89例 ,4 4例疗程有中断。总的 1、2、3年生存率分别为 76%、3 9%、2 3 %;局部控制率分别为 64 %、4 2 %、4 0 %;无远处转移者 1、2、3年生存率分别为 70 %、52 %、3 6%。3 3 %( 44 /1 3 5)未接受连续放疗 ,中断原因 :患者不能耐受 3 1例 ,化疗 4例 ,其他 9例。不同放疗分割方式及辅助化疗对疗程中断无影响 ( P>0 .0 5)。放疗连续组与中断组比较 ,放疗疗程中断明显影响生存率 ( P<0 .0 5)、局控率 ( P<0 .0 1 )。　结论　老年 NSCLC完成根治性放疗后有较好的疗效。部分患者对根治性放疗耐受性较差 ,与放疗分割方式及非正规化疗无关。放疗耐受性差的患者预后较差。

Radiotherapy for elderly patients with non small cell lung cancer

Objective To analyse the results of non surgical treatment in elderly with non small cell lung cancer. Methods One hundred and thirty five elderly patients with pathologically confirmed non small cell lung cancer (NSCLC) were treated with conventional or non conventional radiotherapy in this department.Fifty two cases received chemotherapy (median course was 2 cycles). Results Evaluation was made at the end of 1,2 and 3 years; the survival rate was 76%,39%,23% respectively, local control rate was 64%,42%,40% and metastasis free survival rate was 70%,52%,36%. Irradiation course was prolonged in 33%(44/135) patients. The reasons for prolonged irradiation were patient intolerance (31 cases) and combination with chemotherapy (4 cases) and others (9 cases).Both chemotherapy and non conventional fractionated radiotherapy had no effect on the prolonged course of irradiation ( P >0 05). The prolonged course, when compared with continuous one, significantly affects the survival rate ( P <0 05) and local control rate ( P <0 01). Conclusions Elderly with NSCLC had a good prognosis after treatment. The tolerance to radical radiotherapy in some of the elderly with NSCLC was low and the elderly with lower tolerance had a poorer prognosis.