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目的回顾性比较ⅢA期非小细胞肺癌(NSCLC)术后三维适形放疗(3DCRT组)和常规放疗(CRT组)的近期疗效及放疗反应。方法对美国安德森癌症中心收治的114例ⅢA期NSCLC患者的术后放疗资料进行回顾性分析。CRT组63例,3DCRT组51例。CRT组放疗中位剂量为53．5 Gy分27次,3DCRT组的为52．8 Gy分26次,均在5～6周内完成。结果CRT、3DCRT组中位随访时间分别为28、13个月。两组近期放疗反应、局部控制率及无远处转移生存率等无差异。1、2年总生存率CRT组为80%、62%,3DCRT组为93%、70%。1、2年无瘤生存率CRT组为62%、44%,3DCRT组为58%、32%。两组死亡原因有统计学差异,CRT组有4例死于与心脏损伤有关的并发症,而3DCRT组则无。结论ⅢA期NSCLC术后三维适形放疗可取得与常规放疗类似的近期疗效而并不增加局部复发和远处转移的危险性,对心脏的损伤有降低趋势,对生存率影响则有待更长时间的随访结果。
Objective To retrospectively compare the short-term efficacy and radiotherapy response of patients with stage Ⅲ A non-small cell lung cancer (NSCLC) with 3DCRT and conventional radiotherapy (CRT). Methods The data of postoperative radiotherapy in 114 patients with stage Ⅲ A NSCLC admitted to the Anderson Cancer Center in the United States were retrospectively analyzed. 63 cases of CRT group, 51 cases of 3DCRT group. The median dose of radiotherapy in CRT group was 27 times at 53.5 Gy and 52.8 Gy in 3DCRT group, all of which were completed within 5 to 6 weeks. Results The median follow-up time of CRT and 3DCRT group was 28 and 13 months respectively. There was no difference between the two groups in terms of recent radiotherapy response, local control rate, and distant metastasis-free survival rate. The 1-year and 2-year overall survival rates were 80% and 62% in the CRT group and 93% and 70% in the 3DCRT group. The 1-year and 2-year disease-free survival rates were 62% and 44% in the CRT group and 58% and 32% in the 3DCRT group. There were significant differences in the causes of death between the two groups, with 4 patients in the CRT group having died of complications related to cardiac injury, while none in the 3DCRT group. Conclusion Three-dimensional conformal radiotherapy of stage Ⅲ A NSCLC can achieve the similar short-term curative effect as conventional radiotherapy without increasing the risk of local recurrence and distant metastasis, reducing the damage to the heart and long-lasting effect on the survival rate The follow-up results.