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目的 研究三维适形放射治疗常规放射治疗后复发的非小细胞肺癌可行性 ,观察近期疗效及早期并发症的发生率。方法 2 0 0 0年 10月至 2 0 0 1年 2月 ,12例非小细胞肺癌疗后复发病例 ,由美国CMS公司 2 .6 .1三维治疗计划系统设计放射治疗计划 ,剂量体积直方图 (DVH)评价和优化放射治疗计划 ,体部固定装置及多叶光栏技术实施适形放射治疗。计划靶区为临床所见肿瘤区外放 1.0～ 1.5cm ,计划照射剂量为 4 0～ 6 0Gy ,2 .5～ 3.0Gy/次 ,1次 /d ,5d/周。照射方法为固定野、非共面野或旋转弧。计划靶区体积 (PTV)中位体积为 2 95cm3 (76 .4～ 5 12 .4cm3 )。按美国放射肿瘤学协作组(RTOG)和世界卫生组织 (WHO)标准观察急性放射反应及近期疗效。结果 12例患者均顺利完成治疗。初次放射治疗至再放射治疗的中位间隔时间为 19个月 (12～ 32个月 ) ,再放射治疗肿瘤中位剂量5 1.2Gy(42 .0～ 6 7.5Gy)。近期疗效为完全缓解 (CR) 8.3% (1/12 ) ,部分缓解 (PR) 6 6 .7% (8/12 ) ,无变化 (NR) 2 5 .0 % (3/12 ) ,进展 (PD) 0 % (0 /12 ) ,总有效率为 75 .0 % (9/12 )。根据RTOG分级 ,急性放射性食管炎发生率 1～ 2级 16 .7% (2 /12 ) ,3级 0 % (0 /12 ) ;急性放射性肺炎发生率 1～ 2级 16 .7% (2 /12 ) ,3级 0 % (0 /1
Objective To study the feasibility of three-dimensional conformal radiotherapy for recurrence of non-small cell lung cancer after conventional radiotherapy and to observe the short-term curative effect and the incidence of early complications. Methods From October 2000 to February 2001, 12 cases of non-small cell lung cancer recurrence after treatment by the United States CMS company 2.6.1 three-dimensional treatment planning system design radiation therapy plan, dose volume histogram (DVH) to evaluate and optimize radiotherapy programs, body fixtures and multi-leaf light bar technology. The planned target area is 1.0-1.5 cm outside the tumor area of the clinic, and the planned irradiation dose is 40-60 Gy, 2.5-3.0 Gy / time, 1 time / d and 5 days / week. Irradiation method is fixed field, non-coplanar field or rotating arc. The planned volume of target volume (PTV) median volume of 2 95cm3 (76 .4 ~ 5 12 .4cm3). According to the American Radiation Oncology Group (RTOG) and the World Health Organization (WHO) standards for acute radiation response and short-term efficacy. Results All 12 patients completed the treatment successfully. The median interval between initial radiotherapy and re-radiation was 19 months (range, 12 to 32 months), followed by a median radiation dose of 5 1.2 Gy (42.0 to 7.55 Gy). The immediate effect was 8.3% (1/12) for complete remission (CR), 6.6% (6/12) for partial response (6/12), 2.5% (3/12) for no change PD) 0% (0/12), the total effective rate was 75 .0% (9/12). According to the RTOG classification, the incidence of acute radiation esophagitis was 16.7% (2/12) in grade 1 ~ 2 and 0% (0/12) in grade 3; the incidence of acute radiation pneumonitis was 1 ~ 2 grade 16.7% (2 / 12), Level 3 0% (0/1