论文部分内容阅读
目的评价后程大分割三维适形放疗(3DCRT)Ⅲ期非小细胞肺癌(NSCLC)的疗效与并发症。方法60例Ⅲ期NSCLC随机均分成后程大分割3DCRT组(A组)和常规分割3DCRT组(B组)。A组先接受常规分割放疗(2 Gy/次,5次/周)40 Gy,然后接受后程大分割放疗(4 Gy/次,3次/周)至56 Gy或60 Gy;B组均接受常规分割放疗至60～66 Gy。两组均在放疗第1天接受1个疗程NP方案化疗,放疗结束后接受3个疗程NP方案化疗,NP方案为长春瑞滨25 mg/m~2第1、8天,顺铂30 mg/m~2连用3 d。结果后程大分割放疗组、常规分割组完全缓解率分别为47%、20%(P<0.01),部分缓解率无差异;1～3年生存率曲线比较差异有统计学意义(X~2=4.20,P<0.05),中位生存时间分别为26、12个月;放射性食管炎、放射性肺炎的发生率无差异。结论后程大分割三维适形放疗Ⅲ期NSCL的效果优于常规分割放疗,且毒副反应相当。
Objective To evaluate the efficacy and complications of late course large-segment three-dimensional conformal radiotherapy (3DCRT) stage Ⅲ non-small cell lung cancer (NSCLC). Methods Sixty patients with stage Ⅲ NSCLC were randomly divided into two groups: the 3DCRT group (group A) and the 3DCRT group (group B). Group A received 40 Gy of conventional fractionated radiotherapy (2 Gy / time, 5 times / week) and then received late-stage large fractionated radiotherapy (4 Gy / time, 3 times / week) to 56 Gy or 60 Gy; Routine radiotherapy to 60 ~ 66 Gy. Both groups received one course of NP regimen on the first day of radiotherapy and three courses of NP regimen after the end of radiotherapy. The regimens of NP were vinorelbine 25 mg / m ~ 2 on day 1 and day 18, cisplatin 30 mg / m ~ 2 for 3 d. The results showed that the complete remission rate was 47% and 20% respectively (P <0.01), and the partial remission rate was no difference. The difference of survival rate between 1 and 3 years was statistically significant (X ~ 2 = 4.20, P <0.05). The median survival time was 26 and 12 months respectively. There was no difference in the incidence of radiation esophagitis and radiation pneumonitis. Conclusion The effect of dividing the three-dimensional conformal radiotherapy Ⅲ-phase NSCL after the procedure is superior to conventional radiotherapy, and the side effects are quite similar.