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目的分析非小细胞肺癌患者的三维适形放射治疗的疗效及影响患者生存率的相关因素。方法回顾性分析我科自2005年4月至2010年5月收治的136例非小细胞肺癌患者,全部接受三维适形放射治疗,通过搜集病例资料及长期随访,用单因素和多因素分析患者生存时间及其影响因素。结果 136例患者施行三维适形放射治疗后的近期疗效观察,完全缓解(CR)14.7%(20/136),部分缓解(PR)60.3%(82/136),稳定(SD)19.9%(27/136),进展(PD)5.1%(7/136),总有效率(CR+PR)75%(102/136)。1、2、3、5年生存率分别为79.4%、45.4%、22.1%、12.5%。副反应:1级放射性食管炎35例,2级放射性食管炎16例,3级以上放射性食管炎0例;1级放射性肺炎20例,2级放射性肺炎9例,3级以上放射性肺炎0例。单因素分析显示性别,年龄,病理,分期,剂量,初治疗效对于患者生存时间的影响有统计学意义。多因素分析显示KPS评分,分期,剂量,初治疗效是影响患者长期生存的独立风险因素。结论三维适形放射治疗对非小细胞肺癌患者是一项安全,有效的治疗方法,毒副反应发生率低,且患者放疗后生存期长。
Objective To analyze the curative effect of three-dimensional conformal radiotherapy in patients with non-small cell lung cancer and related factors that influence the survival rate of patients. Methods A retrospective analysis of 136 patients with non-small cell lung cancer admitted to our department from April 2005 to May 2010, all received three-dimensional conformal radiotherapy. By collecting case data and long-term follow-up, using univariate and multivariate analysis Survival time and its influencing factors. Results The immediate effect of three-dimensional conformal radiotherapy was observed in 136 patients. The complete response (CR) was 14.7% (20/136), partial remission (60.3%) was 82/136, and SD was 19.9% (27 / 136), progression (PD) 5.1% (7/136), and total effective rate (CR + PR) 75% (102/136). The 1, 2, 3, 5-year survival rates were 79.4%, 45.4%, 22.1% and 12.5% respectively. Side effects: Grade 1 esophagitis in 35 cases, grade 2 esophagitis in 16 cases, grade 3 in 0 cases of esophagitis; grade 1 in 20 cases of radiation pneumonitis, grade 2 in 9 cases of radiation pneumonitis, grade 3 in 0 cases of radiation pneumonitis. Univariate analysis showed that gender, age, pathology, staging, dose, initial treatment effect on the survival time of patients was statistically significant. Multivariate analysis showed that KPS score, staging, dose, initial treatment efficacy were independent risk factors affecting long-term survival of patients. Conclusion Three-dimensional conformal radiotherapy is a safe and effective treatment for patients with non-small cell lung cancer. The incidence of toxic and side effects is low and patients have long survival after radiotherapy.