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目的评价放弃选择性区域淋巴结照射的三维适形放疗Ⅰ期非小细胞肺癌的毒性和疗效。方法30例经病理组织学和(或)细胞学确诊的Ⅰ期非小细胞肺癌患者接受三维适形放疗,分割剂量3～6Gy/次,5次/周,放疗总量DT63～72Gy。靶区仅包括肿瘤原发灶。结果总有效率为97%。1、2、3年局部控制率分别为73%、60%、53%。1、2、3年生存率分别为72%、56%、52%。随访满5年的12例,5年生存率为35%。未出现3级以上放射性肺炎和放射性食管炎。3例在随访期间出现选择性淋巴结失败。结论三维适形放疗非手术的Ⅰ期非小细胞肺癌安全、有效,近期疗效满意,远期疗效需要进一步观察。放弃选择性区域淋巴结照射并没有明显增加区域淋巴结的复发率。
Objective To evaluate the toxicity and efficacy of three-dimensional conformal radiotherapy (NSCLC) in stage Ⅰ non-small cell lung cancer (NSCLC) given selective regional lymph node irradiation. Methods Thirty patients with stage I non-small cell lung cancer diagnosed by histopathology and / or cytology underwent three-dimensional conformal radiotherapy at a dose of 3-6 Gy / time for 5 times a week for a total of DT63-72 Gy. The target area only includes the primary tumor. The total effective rate was 97%. The local control rates in 1, 2 and 3 years were 73%, 60% and 53% respectively. The 1, 2, 3 year survival rates were 72%, 56%, 52% respectively. Followed up for 5 years in 12 cases, 5-year survival rate was 35%. No grade 3 or more radiation pneumonitis and esophagitis were found. Three patients showed selective lymph node failure during follow-up. Conclusion Three-dimensional conformal radiotherapy for non-surgical stage Ⅰ non-small cell lung cancer is safe and effective. The short-term curative effect is satisfactory. The long-term curative effect needs further observation. To give up selective regional lymph node irradiation did not significantly increase the regional lymph node recurrence rate.