摘要
目的:评价三维适形调强放疗联合化疗在治疗中、晚期非小细胞肺癌(NSCLC)的作用.方法:72例中、晚期NSCLC患者采用分组治疗.A组采用常规放疗加化疗,共30例;B组采用三维适形放疗加化疗,共30例;C组采用三维适形调强放疗加化疗,共12例.三组均采用铂类联合盖诺方案化疗1个周期后放疗,放疗结束后再化疗3～5个周期.结果:A组有效率(CR+PR)43.3%,B组有效率70%.0,C组有效率83.3%,A组与B组,A组与C组差异有统计学意义,P＜0.05;1年生存率:A组40.0%(8/20),B组为66.7%(12/18),C组为100.0%(4/4).B、C组合并后的1年生存率与A组差异有统计学意义,P=0.03;三组的骨髓抑制等基本相同;放射性食管炎,三组间差异无统计学意义,P=0.16.急性放射性肺炎:A组56.7%,B组33.3%;C组16.7%.A组与C组差异有统计学意义,P=0.031.结论:在中、晚期NSCLC的治疗中,三维适形或调强放疗联合化疗与与常规放疗联合化疗相比,具有疗效好、毒副反应轻、患者容易耐受等特点;适形调强放疗在不增加放疗不良反应的同时,能够提高1年生存率和靶区的照射剂量.
OBJECTIVE：To evaluate the effect of intensity modulated radiation therapy （IMRT） for medium and late stage non small cell lung cancer. METHODS： Seventy-two patients with medium and late stage non-small-cell lung cancer were grouped. Group A consisted of 30 patients, receiving conventional radiotherapy plus chemotherapy. Group B consisted of 30 patients, treated with three-dimensional conformal radiotherapy （3-DCRT） plus chemotherapy. Twelve patients were involved in Group C, and IMRT in conjunction with chemotherapy was performed in this group. All these patients received one cycle chemotherapy of Navetbine＋Cisplatin （NP） before radiotherapy and other three to five cycles after radiotherapy. RESULTS： The overall response rate （CR＋PR） was 43. 3% in Group A, and 70. 0%, 83. 3% in Group B and C respectively. In Group A there was a significant difference （P〈0. 05） compared with Group B. The same result could be seen between Group A and C. In terms of one-year survival rate, it was 40% in Group A, and 66. 7%, 100.0% in Group B and C respectively. The one-year survival rate in combination with Group B and C was statistically different from that in Group A, P= 0. 03. Myelosuppression in the three groups was similar. Esophageal toxicity was also observed. There was no statistical difference among the three Groups, P= 0. 16. Acute radiation-induced pulmonitis was 56. 7% in Group A, 33. 3% in Group B and 15. 7% in Group C. Significant difference was found between Group A and Group C, P=0. 031. CONCLUSIONS： 3-DCRT or IMRT combined with chemotherapy in the treatment of non-small cell lung cancer has the feature of good efficacy, less side effects and well-tolerated approach, in contrast with the conventional radiotherapy plus chemotherapy. IMRT can increase not only the one-year survival rate but radiation dose for target, without enhancing the side effect of radiotherapy.
出处
《肿瘤防治杂志》
2005年第18期1388-1390,共3页
China Journal of Cancer Prevention and Treatment
关键词
癌
非小细胞肺/放射疗法
癌
非小细胞肺/药物疗法
综合疗法
carcinoma, non-small cell lung/rdiotherapy
carcinoma, non-small cell lung/drug therapy
combined modality therapy
