【摘要】 目的比较全脑放疗+同步推量适形放疗(SIB-CRT)与全脑放疗后序贯推量适形放疗(SCRT)治疗非小细胞肺癌(NSCLC)合并脑转移瘤的治疗效果。方法 65例NSCLC合并1~3个脑转移瘤患者,分为同步组32例、序贯组33例,分别采用全脑放疗(38.7 Gy/18 f)+SIB-CRT(脑转移瘤52.2 Gy/18 f)、全脑放疗(30 Gy/10 f)后SCRT(脑转移瘤21 Gy/7 f)。比较两组的住院时间、近期疗效、中位生存时间以及6个月、1年、2年生存率。结果放疗后1个月,同步组的客观缓解率及疾病控制率分别为78.1%、100.0%,分别高于序贯组的45.5%、81.8%(P<0.05)。同步组的中位生存期为17.0个月,长于序贯组的11.0个月(P<0.05)。同步组6个月、1年、2年生存率分别为93.8%、67.8%、32.1%,分别高于序贯组的75.8%、48.5%、9.7%(P<0.05)。颅脑放疗方式与患者的生存时间相关(P<0.05),序贯组患者的死亡风险是同步组患者的2.55倍。结论对于合并1~3个脑转移瘤的NSCLC患者,全脑放疗+SIB-CRT的疗效优于全脑放疗后SCRT。更多还原

【Abstract】 Objective To compare the therapeutic efficacy of whole brain radiotherapy (WBRT) and simultaneous integrated boost conformal radiotherapy (SIB-CRT) with the efficacy of sequential conformal radiotherapy (SCRT) after WBRT for non-small cell lung cancer (NSCLC) complicated with brain metastasis.Methods Sixty-five NSCLC patients with one to three brain metastases were divided into simultaneous group (n = 32) and sequential group (n = 33).The simultaneous group and the sequential group underwent WBRT (38.7 Gy/18 f)plus SIB-CRT (brain metastasis,52.2 Gy/18 f) and SCRT (brain metastasis,21 Gy/7 f) after WBRT (30 Gy/10 f) respectively.The hospital stay,short-term efficacy,median survival time,6-month,1-and 2-year survival rates were compared between the two groups.Results After one month of radiotherapy,the objective remission rate and disease control rate in the simultaneous group were higher than those in the sequential group (78.1% vs 45.5%; 100.0% vs 81.8%; P < 0.05).The median survival time of the simultaneous group was longer than that of the sequential group (17.0 months vs 11.0 months; P < 0.05).The 6-month,1-and 2-year survival rates of the simultaneous group were higher than those of the sequential group (93.8% vs 75.8%; 67.8% vs 48.5%; 32.1% vs 9.7%; P < 0.05).The brain radiotherapy approach correlated with patients’ survival time (P < 0.05),the mortality risk of the patients in the sequential group was 2.55 times the risk of the patients in the simultaneous group.Conclusion For the patients with one to three brain metastases from NSCLC,the efficacy of WBRT and SIB-CRT is superior to that of SCRT after WBRT.更多还原