论文部分内容阅读
背景与目的:非小细胞肺癌术后三维适形放疗与常规放疗的疗效比较目前尚缺乏长期随访结果。本研究回顾性分析非小细胞肺癌(NSCLC)术后分别采用三维适形放疗和常规放疗的疗效及放疗反应,比较不同放疗技术对疗效及放疗反应的影响。方法:收集1990年12月—2002年8月美国M.D.安德森癌症研究中心收治的167例ⅢA期NSCLC患者的术后放疗资料进行回顾性分析。其中常规放疗组(CV组)90例,三维适形放疗组(CF组)77例。CV组放疗中位剂量为54.3Gy/27次,CF组放疗中位剂量为53.9Gy/26次,均在5~6周内完成。结果:两组患者病例特征具有可比性。CV组和CF组中位随访时间分别为36个月和24个月,两组无瘤生存率、局部控制率及无远处转移生存率差异无显著性,但两组总生存率差异有显著性(P=0.014)。CF组在肺部纤维化、心脏损伤和血液系统放疗反应发生率显著性上要低于CV组,其余放疗反应差异基本无显著性。两组死亡原因差异有显著性,CV组有8例患者死于与心脏损伤有关的并发症,而CF组没有。结论:ⅢA期NSCLC术后采用改进的三维适形放疗技术不仅可以取得与常规放疗类似的疗效,还可提高总生存率,同时降低了肺部纤维化、心脏损伤和血液系统反应发生率,三维适形放疗的治疗优势值得关注。
BACKGROUND & OBJECTIVE: To compare the efficacy of three-dimensional conformal radiotherapy and conventional radiotherapy for non-small cell lung cancer after long-term follow-up. This study retrospectively analyzed the efficacy and radiotherapy response of three-dimensional conformal radiotherapy and conventional radiotherapy after non-small cell lung cancer (NSCLC) surgery and compared the effects of different radiotherapy techniques on the efficacy and radiotherapy response. Methods: The data of postoperative radiotherapy in 167 patients with stage Ⅲ A NSCLC admitted from the American M.D. Anderson Cancer Center from December 1990 to August 2002 were retrospectively analyzed. The conventional radiotherapy group (CV group) 90 cases, three-dimensional conformal radiotherapy group (CF group) 77 cases. The median dose of radiotherapy in CV group was 54.3 Gy / 27 times and the median dose of radiotherapy in CF group was 53.9 Gy / 26 times, all within 5 ~ 6 weeks. Results: The characteristics of the two groups of patients were comparable. The median follow-up time was 36 months and 24 months in CV group and CF group respectively. There was no significant difference between the two groups in tumor-free survival rate, local control rate and distant metastasis-free survival rate, but there was significant difference between the two groups Sex (P = 0.014). In CF group, the incidence of pulmonary fibrosis, cardiac injury and hematologic response to radiotherapy was significantly lower than that of CV group, with no significant difference in other radiotherapy responses. There were significant differences in the causes of death between the two groups, with 8 patients in the CV group having died of complications related to cardiac injury, while none in the CF group. Conclusion: The improved three-dimensional conformal radiotherapy for stage Ⅲ A NSCLC can not only achieve the same curative effect as conventional radiotherapy, but also improve the overall survival rate, reduce the incidence of pulmonary fibrosis, cardiac injury and hematological response. The three-dimensional Therapeutic advantages of conformal radiotherapy deserve attention.