| 修霞,邓湘,李明昱,等.早期非小细胞肺癌三维适形放射治疗的疗效[J].中华放射医学与防护杂志,2007,27(1):73-75.XIU Xia,DENG Xiang,et al.Clinical analysis of 3DCRT for early stage non small cell lung cancer[J].Chin J Radiol Med Prot,2007,27(1):73-75 |
| 早期非小细胞肺癌三维适形放射治疗的疗效 |
| Clinical analysis of 3DCRT for early stage non small cell lung cancer |
| 投稿时间：2006-10-08 |
| DOI： |
| 中文关键词: 非小细胞肺癌 放射治疗 三维适形放射治疗 |
| 英文关键词:Non small cell lung cancer Radiotherapy 3DCRT |
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| 中文摘要: |
| 目的 探讨三维适形放射治疗早期非小细胞肺癌的疗效和放射反应。方法 对36例临床Ⅰ～Ⅱ非小细胞肺癌行三维适形放射治疗,病人年龄58～88岁,中位年龄74岁,Ⅰ期25例,Ⅱ期11例,病灶小于3 cm 17例,3 cm以上19例。采用真空袋固定,Philips公司CT模拟机定位及VARIAN公司的Eclipse三维治疗计划。小于3 cm病灶采用弧形照射结合2～3个适形固定野,剂量10～15 Gy/次,共3～5次;3 cm以上病灶采用非共面适形野,剂量5～8 Gy/次,共6～12次,计划要求95%以上PTV体积接受95%以上剂量。按100%等剂量线计算处方剂量,全肺V20控制在≤25%。结果 近期疗效中完全缓解(CR)率为53%,部分缓解(PR)率为36%,无进展(NR)率为11%,总有效率(CR+PR)为89%。肿瘤直径小于3 cm者CR率为76.5%,而3 cm以上者CR率为31.5%,差异有统计学意义(P<0.025)。1、2、3年生存率分别为83.3%、52.4%、 38.5%。Ⅰ期、Ⅱ期1年生存率分别为96%、54.5%,差异有统计学意义(P<0.01),2年生存率分别为57%、43%。放射性肺反应早期多为0级,Ⅰ级9例,Ⅱ级3例,晚期肺反应多为Ⅰ级,Ⅱ级6例,无Ⅱ级以上早期及晚期放射性肺损伤。结论 三维适形放射治疗技术治疗早期非小细胞肺癌是安全、有效的,具有较好的近期及远期疗效,失败原因主要为远处转移。 |
| 英文摘要: |
| Objective To evaluate the result and radiation reaction of three-dimensional conformal radiotherapy (3DCRT) for non small cell lung cancer. Methods 36 patients with stage Ⅰ-Ⅱ non-small cell lung cancer were treated with 3DCRT radiotherapy. Patients were 58-88 years old, and the median age was 74. 25 patients were on stage Ⅰ, and 11 patients were on stage Ⅱ. 17 patients had tumor<3 cm and 19 patients had tumor with size ≥3 cm. Vacuum bag were used. Philips CT simulation and three dimensional treatment plans were used. Tumor with size <3 cm had arc and 2-3 fixed conformal field irradiation, with dose 10-15Gy/fraction, totally 3-5 fractions. Tumor with size ≥3cm had 3-dimensional conformal field, with dose 5-8 Gy/fraction, totally 6-12 fractions. The treatment plans require that more than 95% PTV volume receive more than 95% dose. Results The short term treatment result showed that the complete response (CR) rate was 53%, the partial response (PR) rate was 36%, and the overall response(CR+PR) rate was 89%. CR rate for tumor<3 cm was 76.5%, and CR rate for tumor≥3 cm was 31.5%, the difference was significant (P<0.025). 1, 2 and 3-year survival rate were 83.3%, 52.4% and 38.5%, respectively. 1-year survival rate for stage Ⅰ and stage Ⅱ were 96% and 54.5% with the difference significant (P<0.01). 2-year survival rate for stage Ⅰ and stage Ⅱ were 57%and 43%. Acute radiation pneumonitis were mostly RTOG Grade 0, 9 patients had Grade 1 and 3 patients had Grade 2. Late radiation pulmonary fibrosis were mostly Grade 1, 6 patients had Grade 2. There was no acute and late radiation pneumonitis above Grade 2. Conclusions 3DCRT for early stage non small cell lung cancer is safe and effective. The short term and long term treatment result is better. The major pattern of failure is distant metastasis. |
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