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目的 观察后程立体定向放射治疗Ⅲb 期肺鳞癌的近期疗效与急性放射反应。方法 136例Ⅲb 期肺鳞癌患者进入后程立体定向放射治疗组 ,常规放射治疗 40Gy后给予残存肿瘤灶立体定向放射治疗 ,5～ 8Gy/次 ,隔日 1次 ,肿瘤灶总剂量 2 4～ 38Gy。结果 136例中有 5例未完成治疗计划 ,按计划完成的 131例中 ,急性放射性食管炎 (RTOG标准 )占 45 .5 % ,其中Ⅲ级占 4.4% ;急性放射性肺炎占 2 2 .0 % ,其中Ⅲ级占 5 .2 %。原发灶完全缓解 (CR)占 2 0 .6 % ,部分缓解 (PR)占 6 5 .7% ,无变化和进展 (NR +PD)占 13.7% ,总有效率为 86 .3% ;纵隔转移淋巴结完全缓解 (CR)占 39.7% ,部分缓解 (PR) 5 2 .7% ,无变化和进展 (NR +PD)为 7.6 % ,总有效率为 92 .4%。结论 后程立体定向放射治疗Ⅲb 期肺鳞癌能为绝大多数患者耐受 ,有较好的近期疗效。远期疗效及晚期并发症有待进一步随访证实
Objective To observe the short-term efficacy and acute radiation response of late-stage stereotactic radiotherapy for stage IIIb squamous cell carcinoma of the lung. METHODS: One hundred and thirty-six patients with stage IIIb squamous cell carcinoma were enrolled in the postoperative stereotactic radiotherapy group. After conventional radiotherapy for 40 Gy, stereotactic radiotherapy for residual tumours was performed, 5-8 Gy/time, every other day. The total dose of tumor foci was 24 to 38 Gy. . Results Among the 136 cases, 5 cases did not complete the treatment plan. Among the 131 cases completed according to the plan, acute radiation esophagitis (RTOG standard) accounted for 45.5%, of which grade III accounted for 4.4%; acute radiation pneumonia accounted for 22.0% Of which, Class III accounted for 5.2%. The primary tumor complete remission (CR) accounted for 20.6%, partial remission (PR) accounted for 65.7%, no change and progression (NR + PD) accounted for 13.7%, the total effective rate was 86.3%; mediastinum Complete lymph node metastasis (CR) accounted for 39.7%, partial remission (PR) 5 2.7%, no change and progression (NR +PD) was 7.6%, and the total effective rate was 92.4%. Conclusion Late stage stereotactic radiotherapy for stage IIIb lung squamous cell carcinoma can be tolerated in most patients and has a good short-term efficacy. Long-term efficacy and late complications need further follow-up confirmed