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目的：了解外照射结合高剂量率腔内照射治疗非小细胞肺癌长期疗效。方法：１９９０年１２月至１９９３年１２月间，我院外照射结合高剂量率腔内照射治疗非小细胞肺癌资料完整者４５例。外照射开始射野包括原发灶、肺门、纵隔淋巴结。前后对穿照射剂量达４０Ｇｙ后，避开脊髓水平照射或前后对穿照射，外照射剂量７８％的患者接受ＤＴ ６０Ｇｙ；腔内近距离治疗采用高剂量率Ｍｉｃｒｏ Ｓｅｌｅｃｔｒｏｎ后装治疗机，通过光导纤维支气管镜将导管插入病变部位的叶或段支气管内，每次置管１～２根，剂量参考点均选在施用器中轴外１０ｍｍ处，剂量为５～２４Ｇｙ／１～３次，腔内治疗在外照射之前、之中或之后进行，腔内治疗的当日不作外照射。结果：本组１、３、５年生存率分别为４８．９％２２／４５、１５．６％７／４５、８．９％４／４５，与我院单纯外照射治疗非小细胞肺癌的先期资料对比，两者１、３、５年生存率无明显差别。结论：１外照射结合高剂量率腔内照射治疗中晚期非小细胞肺癌不能明显改善远期生存率，但有利于肿瘤复发的再治疗。２适当的高剂量率腔内治疗不增加远期并发症。
Objective: To understand the long-term efficacy of external irradiation combined with high-dose-rate intraluminal irradiation in the treatment of non-small cell lung cancer. Methods: From December 1990 to December 1993, 45 patients with intact data of non-small cell lung cancer were treated with external irradiation combined with high-dose-rate intraluminal irradiation. The initial field of external radiation includes the primary tumor, hilar and mediastinal lymph nodes. Before and after the exposure dose of 40Gy, avoid spinal cord horizontal irradiation or before and after the right exposure, external exposure dose of 78% of patients received DT 60Gy; intracavitary brachytherapy using high dose rate Micro Selectron aftertreatment machine, through the optical fiber The bronchoscope inserted the catheter into the leaf or segment bronchus of the lesion. Each time the catheter was placed with 1-2 catheters, the dose reference point was selected in the applicator outside the axis 10mm, the dose was 5 ~ 24Gy / 1 ~ 3 times, intraluminal The treatment was performed before, during, or after external exposure, and no external irradiation was performed on the day of endovascular treatment. Results: The 1-, 3-, and 5-year survival rates in this group were 48.9%, 22/45, 15.6%, 7/45, 8.9%, and 4/45, respectively. There was no significant difference in the 1-, 3-, and 5-year survival rates for the treatment of non-small cell lung cancer. Conclusion: 1. External irradiation combined with high dose rate intraluminal irradiation for the treatment of advanced non-small cell lung cancer can not significantly improve the long-term survival rate, but is conducive to the re-treatment of tumor recurrence. 2 The appropriate high dose rate endovascular treatment does not increase long-term complications.