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目的探讨肿瘤体积和放疗剂量对局部晚期非小细胞肺癌(NSCLC)三维适形放疗(3DCRT)预后的影响。方法 78例接受3D-CRT的局部晚期NSCLC患者为研究对象,利用三维适形放射计划系统和CT扫描勾画相应靶区,分别定义为GTV-T、GTV-P和GTV-N,分析各靶区肿瘤体积和放疗剂量对3D-CRT的预后效果。结果全组研究对象中肿瘤最大直径<5.00 cm的患者生存率高于肿瘤最大直径≥5.00 cm的患者(P<0.05);GTV-T<100.00 cm3的患者生存率明显高于GTV-T≥100.00 cm3的患者(P<0.05)。分层分析显示放疗处方剂量≤66 Gy亚组中,肿瘤大体体积越小,生存率越高。结论应用三维适形放射计划系统和CT扫描所勾画的大体肿瘤体积对接受放疗的NSCLC患者长期生存率有显著影响;对体积小的肿瘤行大剂量放疗对局部晚期NSCLC患者的生存有益。
Objective To investigate the effects of tumor volume and radiation dose on the prognosis of locally advanced non-small cell lung cancer (NSCLC) in three-dimensional conformal radiotherapy (3DCRT). Methods Seventy-eight patients with locally advanced NSCLC who underwent 3D-CRT were enrolled. The corresponding target regions were delineated by three-dimensional conformal radiation planning system and CT scan, which were defined as GTV-T, GTV-P and GTV-N, Prognostic effect of tumor volume and radiotherapy dose on 3D-CRT. Results The survival rate of patients with tumor maximum diameter <5.00 cm was higher than that of patients with tumor diameter ≥5.00 cm (P <0.05). The survival rate of patients with GTV-T <100.00 cm3 was significantly higher than that of patients with GTV-T≥100.00 cm3 patients (P <0.05). Hierarchical analysis showed that the smaller the tumor volume was, the higher the survival rate was. Conclusions The gross tumor volume delineated by three-dimensional conformal radiation planning system and CT scan has a significant effect on the long-term survival rate of NSCLC patients undergoing radiotherapy. Large dose radiotherapy is beneficial to the survival of patients with locally advanced NSCLC.