摘要
本文综述了近三年来在局部晚期非小细胞肺癌放射治疗方面的临床研究进展。①术前的诱导治疗 ,包括术前的化疗或术前放化疗综合应用。②能手术切除病人的化放疗综合治疗 ,提出了除手术治疗外 ,综合使用化疗和放射治疗是这些病人的另一个选择。③不能手术切除病人的化疗和放疗。强调了全身化疗的重要性 ,讨论了化放综合治疗的模式及其疗效和治疗并发症。④三维适形放疗 ,已有的文献支持该方法能较好地保护肺组织 ,从而提高肿瘤的照射剂量。因此肿瘤的局控率和生存率均有明显改善。⑤非常规分割放疗。加速超分割放疗在一个较短的照射时间内给一个相对高的放射剂量 ,结果显示提高了局控率。因而有继续研究的前景。⑥放疗保护剂的试用。Amifostine已被用于肺癌的放疗 ,实践证实能减少放射性肺炎和食管炎的产生。
This article reviewed the latest developments in radiotherapy for locally advanced non small cell lung carcinomas (LANSCLC) in the past three years. ①Induction therapy before surgery, which includes chemotherapy and chemo radiotherapy. ②Chemo radiotherapy for resectable LANSCLC. It is suggested that chemo radiotherapy would be one of the choices, besides surgery. ③Chemo radiotherapy for unresectable LANSCLC. Chemotherapy is emphasized to play an important role for these patients. The models of combination of chemotherapy and irradiation are also discussed, and so are the efficacy, toxicity and tolerance. ④Three dimensional conformal radiotherapy (3DCRT). It has been demonstrated that 3DCRT could protect normal lung well, which surrounds the tumor. Therefore, irradiation dose could be increased, and local control as well as survival would be improved by this way. ⑤Unconventional fractionated irradiation. Accelerated hyperfractionated radiation therapy, which shortens the total treatment time and still remains a high dose, has resulted in good outcome. Therefore, there is a room for further studies. ⑥Application of radioprotector in lung irradiation. Amifostine has been tried and shown to have protection for normal tissues, especially in decreasing the incidences of radiation induced esophagitis and pneumonitis.
出处
《中国癌症杂志》
CAS
CSCD
2003年第5期394-397,共4页
China Oncology
