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目的观察评价体部伽玛刀治疗Ⅰ～Ⅱ期非小细胞肺癌(NSCLC)的近期疗效和放射反应。方法采用国产旋转式体部伽玛刀治疗41例Ⅰ～Ⅱ期非小细胞肺癌,治疗时用真空负压袋固定体位、CT定位扫描和三维计划,靶区在肺窗上勾画,并与纵隔窗比较,PTV在GTV外扩1cm,处方剂量为50%剂量线,5Gy/次,5次/周,肿瘤局部总剂量40～50Gy。结果原发灶的完全缓解率(CR)61%(25/41),部分缓解率(PR)34.1%(14/41),无变化(NC)4.9%(2/41),总有效率95.1%。41例全部按计划完成治疗,放射反应轻微,放射性肺炎Ⅰ级29.3%(12/41),Ⅱ级12.2%(5/41),10例出现放射性食管炎的均为中央型肺癌,Ⅰ级17.1%(7/41),Ⅱ级7.3%(3/41)。1,2年肿瘤局部控制率和总生存率分别为90.2%、82.9%和82.9%、73.2%。结论体部伽玛刀治疗早期非小细胞肺癌近期疗效好,副作用轻微,是一种有效的局部治疗方法。
Objective To evaluate the short-term effect and radiation response of body gamma knife in the treatment of stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC). Methods 41 cases of stage Ⅰ ~ Ⅱ non-small cell lung cancer were treated with a domestic rotating gamma knife. The patients were treated with vacuum-assisted vacuum bag fixation, CT scanning and 3D planning. The target area was outlined on the lung window, Compared with the control group, PTV extended 1cm outside GTV, the prescription dose was 50% dose line, 5Gy / time, 5 times / week, and the total local dose of tumor was 40 ~ 50Gy. Results The complete remission rate (CR) was 61% (25/41), partial response rate (PR) 34.1% (14/41), no change (NC) 4.9% (2/41), the total effective rate 95.1 %. All 41 cases were treated according to plan, with a slight radiation response. Radioactive pneumonitis grade Ⅰ was 29.3% (12/41), grade Ⅱ was 12.2% (5/41). Radiation esophagitis was found in 10 patients with central esophagitis, Grade Ⅰ 17.1 % (7/41), grade II 7.3% (3/41). The local control rates and overall survival rates of tumors at 1 and 2 years were 90.2%, 82.9% and 82.9%, respectively, 73.2%. Conclusion Gamma knife treatment of early non-small cell lung cancer with short-term curative effect, minor side effects, is an effective method of local treatment.