【摘要】 目的:探讨老年人非小细胞肺癌(NSCLC)三维适形放射治疗(3DCRT)的疗效及价值。方法:将132例老年人NSCLC患者随机分为观察组(常规放疗加三维适形放疗)和对照组(常规放疗),各66例,第一阶段两组常规放疗方法相同,先设前后对穿野,20次(5次/周)共照射DT40GY。第二阶段观察组以三维适形放疗,每次DT2～3GY,5次/周,总剂量20～28GY;对照组仍常规放疗避开脊髓共补充DT20GY,5次/周,2周。结果:观察组总有效率95.5%,与对照组(84.9%)比较,有显著性差异(P﹤0.05);观察组平均生存期(26.5±3.5)个月与对照组(18.5±2.5)个月比较,有显著性差异(P﹤0.01);观察组2、3年生存率分别为48.5%、33.3%与对照组的30.3%、16.7%比较,有显著性差异(P﹤0.05);观察组急性放射性反应(放射性肺炎和Ⅰ、Ⅱ期放射性食管炎)与晚期放射性反应(放射性肺纤维化)发生率与对照组比较,均有显著性差异(均P﹤0.01)。结论:老年人NSCLC采用3DCRT,可提高肿瘤病灶放射剂量,减少放疗副反应,提高老年人2、3年生存率和生活质量。更多还原

【Abstract】 Objective:To evaluate the effect and value of three-dimensional conformal radiotherapy(3DCRT) on non-small-cell lung carcinoma(NSCLS)in the elderly.Methods:One hundred and thirty-two cases with NSCLS were randomly divided into conventional radiotherapy plus 3DCRT group and conventional radiotherapy(CT)group.The first stage,both of the two groups were initially treated by the same conventional radiotherapy at a dose of 40 GY,20 fractions for four weeks.The second stage,the patients in 3DCRT group were then administered 3DCRT in 2-3 GY/f,5fractions a week at a dose of 20-28 GY.The patients in CT group received the same CT at a dose of 20 GY,10 fractions for two weeks.Results:The total effective rates were 95.5% in 3DCRT group and 84.9% in CT group.The 2,3-year survival rates were 48.5%,33.3% in 3DCRT group and 30.3%,16.7% in CT group.The difference of the two groups was significant statistically(P﹤0.05).The incidences of radiation pneumonitis,Ⅰ,Ⅱradiation esophagitis and radiation pulmonary fibrosis were milder in the 3DCRT group than that in the CT group.There was significant difference statistically between the two groups(P﹤0.01).Conclusion:In treatment of NSCLC in the elderly,conventional radiotherapy followed by 3DCRT may increase the 2,3-year survival rate,quality of life and decrease the radiation reaction.更多还原