论文部分内容阅读
目的:探讨图像引导大分割调强放疗同步化疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法:2011年8月至2013年4月,44例局部晚期NSCLC患者(ⅢA期20例,ⅢB期24例)行图像引导大分割调强放疗。肺部原发灶计划靶体积总剂量60Gy~72Gy,3Gy~8Gy/次,1次/天,3次~5次/周。患者同步行铂类为基础双药联合方案化疗至少2周期。结果:44例患者,完全缓解(CR)7例,部分缓解(PR)29例,稳定(NC)6例,进展(PD)2例,有效率(RR)81.8%。中位随访时间21个月,1、2年总生存率(OS)和中位生存时间(MST)分别为79.5%、51.3%和25个月。1、2年局部控制率分别为86.4%、59.1%。1、2年无疾病进展生存(PFS)和中位PFS分别为61.2%、38.7%和18个月。3级以上急性放射性肺炎、放射性食道炎发生率分别为6.8%和9.1%。3级以上白细胞、血红蛋白、血小板计数减少率分别为38.6%、6.8%、13.6%。结论:图像引导大分割调强放疗同步化疗治疗局部晚期NSCLC近期疗效和生存率较好,放化疗毒性未见明显增加,耐受性好。
Objective: To investigate the curative effect and toxicity of image-guided massive split-combined radiotherapy and concurrent chemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods: From August 2011 to April 2013, 44 patients with locally advanced NSCLC (20 cases of stage ⅢA and 24 cases of stage ⅢB) underwent guided IMRT. The target volume of the primary lung in the lung is 60Gy ~ 72Gy, 3Gy ~ 8Gy / time, 1 time / day and 3 ~ 5 times / week. Patients underwent platinum-based dual-agent regimen chemotherapy for at least 2 cycles. Results: In 44 patients, there were 7 cases of complete remission (CR), 29 cases of partial remission (PR), 6 cases of stable (NC) and 2 cases of progression (PD). The effective rate was 81.8%. The median follow-up time was 21 months. The 1-year and 2-year OS and MST were 79.5%, 51.3% and 25 months, respectively. The local control rates in 1 and 2 years were 86.4% and 59.1% respectively. The progression-free survival (PFS) and median PFS for 1 and 2 years were 61.2%, 38.7% and 18 months, respectively. Grade 3 and above acute radiation pneumonitis, radiation esophagitis incidence rates were 6.8% and 9.1%. Grade 3 or more white blood cells, hemoglobin, platelet count decreased 38.6%, 6.8%, 13.6%. CONCLUSION: Image-guided large-division IMRT combined with concurrent chemotherapy has good short-term curative effect and survival rate in locally advanced NSCLC with no significant increase in radiotherapy and chemotherapy toxicity and good tolerability.