中华放射医学与防护杂志

刘桂梅,夏广荣,靳国华.局部晚期非小细胞肺癌后程加速超分割放射治疗临床分析[J].中华放射医学与防护杂志,2006,26(4):383-385

局部晚期非小细胞肺癌后程加速超分割放射治疗临床分析

Late-course hyperfractionation accelerated radiotherapy for locally advanced non-small cell lung cancer

投稿时间：2006-04-04

DOI：

英文关键词:Non-small cell lung cancer Late-course hyperfractionation accelerated radiotherapy Prognosis

基金项目:

作者	单位
刘桂梅	101149, 北京胸部肿瘤结核病医院放疗科,
夏广荣	101149, 北京胸部肿瘤结核病医院放疗科,
靳国华	101149, 北京胸部肿瘤结核病医院放疗科,

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中文摘要:

目的观察局部晚期非小细胞肺癌后程加速超分割放射治疗(LCHART)的毒性和疗效。方法 2000年8月至2002年3月56例经病理诊断或细胞学确诊不能手术Ⅲ期非小细胞肺癌患者随机进入研究。放疗第1阶段大野前后对穿垂直照射原发灶、转移淋巴结、同侧肺门和纵隔淋巴引流区,每次2.0Gy,每天1次。总吸收剂量40Gy。第2阶段缩野照射原发灶和转移淋巴结,每次1.5Gy,每天2次,总吸收剂量26～30Gy。结果放疗结束1个月后增强CT评价疗效,56例的有效率为67.9%,其中完全缓解(CR)3例,部分缓解(PR)35例,稳定(SD)14例,进展(PD)4例。中位生存时间12个月,1、2、3、4年总生存率分别为53.6%、19.6%、5.4%、3.6%。Ⅲa、Ⅲb期中位生存期分别为13、9个月。急性放射反应有放射性食管炎2级20例,3级2例;放射性肺炎2级2例;晚期放射性肺损伤2级5例,3级1例。结论后程超分割放射治疗局部晚期非小细胞肺癌剂量能够得到一定的提高,有很好的近期疗效且副作用可以接受。

英文摘要:

Objective To study the toxicities and efficacy of late course hyperfractionation accelerated radiotherapy(LCHART) in unresectable locally advanced non-small cell lung cancer (NSCLC). Methods Fifty-six unresectable stage Ⅲa-Ⅲb NSCLC patients eligible for this study were treated with conventional fractionation radiotherapy (2 Gy/f,1 f/d, 40 Gy in total) with AP-PA large fields encompassing the primary tumor, positive lymph nodes and elective lymph node region,and followed by LCHART(1.5 Gy/f,2 f/d, 26-30 Gy in total) with cone-down fields covering primary tumor.Efficacy was evaluated by enhanced CT scanning. Results The response rate was 67.9% 1 month after completion of radiotherapy.The median survival time (MST) was 12 months.The 1-,2-,3-,and 4-year overall survival rate were 53.6%,19.6%,5.4% and 3.6%,respectively.Grade Ⅱ radiation esophagitis was observed in 20 patients,grade Ⅲ radiation esophagitis in 2 patients; grade Ⅱ radiation pneumonitis in 2 patients; grade Ⅱ late lung fibrosis in 5 patients,and grade Ⅲ in 1 patient.Conclusion The doses used in late-course hyperfractionation accelerated radiotherapy for locally advanced non-small cell lung cancer can be increased noticeably.Late-course hyperfractionation accelerated radiotherapy had excellent short-term effect;its toxicity was acceptable.

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