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目的评价三维适形放疗(3D-CRT)联合化疗治疗Ⅲ期非小细胞肺癌(NSCLC)的临床疗效及并发症。方法分析3D-CRT联合化疗治疗Ⅲ期非小细胞肺癌51例,3D-CRT根据剂量体积直方图给定吸收剂量,总剂量为60～70Gy/8～12次,放疗结束后2周实施化疗,使用诺维本(NVB)30mg/m,第1、8日,顺铂(DDP)20mg/m1～5d,22观察其疗效和并发症。结果51例患者全部完成治疗,无院内死亡。治疗后个月评价近期疗效,1CR14例,PR28例,有效率(CR+PR)为82.4%,不同直径的肿瘤近期疗效不同(=9.73,P<0.05)。随访4～16个月,1年生存率2掊为78.4%(40/51)。不良反应:Ⅰ～Ⅱ级食管炎11例(21.6%),Ⅲ度白细胞减少6例(11.8%),Ⅲ～Ⅳ度外周神经炎2例(4%)。结论3D-CRT治疗肺癌具有明显的剂量分布优势,可显著提高肿瘤的局部控制率,联合NVB+DDP化疗可提高III期NSCLC的治疗效果,而不增加放化疗的并发症。
Objective To evaluate the clinical effects and complications of three-dimensional conformal radiotherapy (3D-CRT) in combination with chemotherapy for stage Ⅲ non-small cell lung cancer (NSCLC). Methods 51 cases of stage Ⅲ non-small cell lung cancer were treated with 3D-CRT combined with chemotherapy. The dose of 3D-CRT was given according to dose-volume histogram. The total dose was 60-70 Gy / 8-12 times. Chemotherapy was performed two weeks after the end of radiotherapy. The efficacy and complications of NVB 30mg / m, day 1, day 8 and cisplatin (DDP) 20mg / m1-5d, 22 were observed. Results 51 patients completed the treatment, no hospital deaths. Short-term curative effect was evaluated one month after treatment, 1CR14 cases and PR28 cases, and the effective rate (CR + PR) was 82.4%. The short-term curative effect of different diameter tumors was different (= 9.73, P <0.05). Follow-up 4 to 16 months, 1-year survival rate of 2 掊 78.4% (40/51). Adverse reactions: grade Ⅰ ~ Ⅱ esophagitis in 11 cases (21.6%), Ⅲ grade leukopenia in 6 cases (11.8%), Ⅲ ~ Ⅳ degree peripheral neuritis in 2 cases (4%). Conclusion 3D-CRT treatment of lung cancer has obvious dose distribution advantage, which can significantly improve the local control rate of tumor. Combined with NVB + DDP chemotherapy can improve the treatment effect of stage III NSCLC without increasing the complications of radiotherapy and chemotherapy.