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[目的]观察立体定向体部放射治疗(SBRT)联合EP方案治疗局部晚期非小细胞肺癌的近期疗效和不良反应。[方法]47例Ⅲ期非小细胞肺癌患者进行同步放化疗,放疗采用伽玛刀:50%剂量线作为处方剂量完全覆盖PTV,60%～70%剂量线包裹95%以上GTV,3～8Gy/次,总剂量40～60Gy,1～3周完成治疗;化疗采用EP方案:VP-1680mg/m2,d1~5,静脉滴注,PDD30mg/m2,d1~3,静脉滴注,于照射当天同时行静脉化疗,21d为1个周期。[结果]所有患者均随访,中位随访时间13个月,其中完全缓解(CR)16例,部分缓解(PR)25例,总有效率为87.2%,1年局控率和生存率分别为90.3%和83.9%;放射性肺炎为其主要不良反应,其发生率为10.6%(5/47)。[结论]SBRT联合EP方案同步放化疗能够有效提高局部晚期非小细胞肺癌的局部控制率和生存率,且不良反应少,对于此类患者是一种安全有效的治疗选择。
[Objective] To observe the short-term curative effect and adverse reaction of stereotactic body radiotherapy (SBRT) combined with EP regimen in the treatment of locally advanced non-small cell lung cancer. [Method] 47 patients with stage Ⅲ non-small cell lung cancer underwent concurrent chemoradiotherapy. The radiation dose of gamma irradiation was 50% of the radiation dose. The dose of radiation covered 95% of the GTV, 3 to 8 Gy The total dose of 40 ~ 60Gy, 1 to 3 weeks to complete the treatment; chemotherapy using EP regimen: VP-1680mg / m2, d1 ~ 5, intravenous drip, PDD30mg / m2, d1 ~ At the same time intravenous chemotherapy, 21d for a cycle. [Results] All the patients were followed up for a median of 13 months. Among them, 16 were complete remission (CR), 25 were partial remission (PR). The total effective rate was 87.2%. The 1-year local control rate and survival rate were 90.3% and 83.9% respectively. Radiation pneumonitis was the main adverse reaction, with a rate of 10.6% (5/47). [Conclusions] SBRT combined with EP regimen concurrent chemoradiotherapy can effectively improve the local control rate and survival rate of locally advanced non-small cell lung cancer with less adverse reactions, which is a safe and effective treatment option for such patients.