【摘要】 目的观察胸部放疗不同分割模式治疗局限期中Ⅲ期小细胞肺癌的疗效及不良反应。方法 45例局限期中Ⅲ期小细胞肺癌患者的临床资料,其中超分割放疗DT 45 Gy组22例,常规分割放疗DT 60 Gy组23例。均采用EP方案化疗联合放疗,超分割组,1.5 Gy/次,2次/d,间隔≥6 h,5 d/周,总剂量DT 45 Gy。常规分割组,2.0 Gy/次,1次/d,5 d/周,放疗至40 Gy时缩野加量照射,总剂量DT 56~60 Gy。对两组的近期有效率,1、2年生存率,放疗不良反应情况进行统计学分析。结果超分割组与常规分割组的近期有效率分别为81.8%和91.3%;1、2年生存率分别为70.7%、35.7%和90.9%、27.9%,差异无统计学意义(P>0.05);中位生存期分别为20个月和20个月。超分割组2级以上放射性食管炎及急性放射性肺炎、3级以上血液学毒性发生率均较常规分割组高。结论超分割放疗与常规分割组治疗局限期中Ⅲ期小细胞肺癌近、远期疗效相似,但超分割组不良反应高,建议对于局限期中Ⅲ期SCLC使用常规分割放疗同步化疗。更多还原

【Abstract】 Objective To observe the efficacy and adverse reactions of thoracic radiation therapy in different segmentation model for limited stage of small cell lung cancer of stage Ⅲ. Methods The clinical data of 45 patients with limited stage of small cell lung cancer patients in stage Ⅲ,including 22 cases of group DT 45 Gy of the hyperfractionated radiotherapy,23 cases of group DT 60 Gy of conventional radiotherapy.EP regimen are used in combination with radiotherapy,hyperfractionated group,1. 5 Gy / times,2 times / d,spacing ≥6 h,5 d / week,total dose DT 45 Gy,conventional fractionation group,2. 0 Gy / times,1 times / d,5 d / week,when the shrinking field radiotherapy to 40 Gy irradiation dosage,the total dose DT 56 ~ 60 Gy. The short- term efficiency of the two groups and 1,2- year survival rates were statistically analyzed. Results The recent efficiency( CR + PR) of hyper- fractionation group and conventional fractionation were 81. 8% and 91. 3%. 1,2 year survival rates were 70. 7%,35. 7% and 90. 9%,27. 9%( P = 0. 942) respectively. The median survival time was 20 and 20 months respectively. The incidence rate of radiation esophagitis,pneumonia and bone marrow suppression of hyper- fractionation group was higher than conventional fractionation group. Conclusion Short- term and long- term clinical effects of hyperfractionated radiotherapy and conventional fractionation in the treatment of limited stage of phase III SCLC are similar,but the rate of adverse reaction of hyper- fractionation group is higher. Thus the authors suggest to use concurrent chemotherapy of the conventional radiotherapy for the limitation period of stage Ⅲ SCLC.更多还原