【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。更多还原

【Abstract】 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.更多还原