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[Ⅲ期非小细胞肺癌患者的晚期三维适形放疗]

[Late course three-dimensional conformal radiotherapy in patients with stage III non-small cell lung cancer].

作者信息

Wang Xi-cheng, Wang Si-yang, Yang Shu, Ding Ying, Shang Yi

机构信息

Department of Radiotherapy, First Affiliated Hospital of Guangdong College of Pharmaceutical Science, Guangzhou 510080, China.

出版信息

Di Yi Jun Yi Da Xue Xue Bao. 2005 Jun;25(6):726-8.

Abstract

OBJECTIVE

To evaluate the therapeutic efficacy and radiation complications of late course three-dimensional conformal radiotherapy (3DCRT) in patients with stage III non-small cell lung cancer (NSCLC).

METHODS

Eighty-six patients with stage III NSCLC were randomly divided into group A (n=42) receiving conventional radiotherapy at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks and group B (n=44) with late course 3DCRT at the dose of 24-30 Gy in 6 fractions (400-500 cGy per fraction every other day) after 40 Gy conventional radiotherapy, completed in 5 to 6 weeks.

RESULTS

The efficacy rates in groups A and B were 55.0% and 82.9%, and the complete remission rates were 7.5% and 31.7% respectively, showing significant difference between the two groups (P<0.05). The 1- and 2-year survival rates of the patients in group A and B were 62.5% vs 78.0%, and 40.0% vs 53.7% respectively, without significant difference (P>0.05). The median survival time in groups A and B were 11.4 months and 19.8 months respectively. The major radiation complications observed in the two groups were grade I to II acute radiation esophagitis and hematopoietic toxicity. The later stage radiation complications in the two groups were grade I to II radiation lung fibrosis, occurring at a similar rate between the two groups.

CONCLUSION

Late course 3DCRT produces better therapeutic effects than conventional radiotherapy in patients with stage III NSCLC.

摘要

目的

评估晚期三维适形放疗(3DCRT)治疗Ⅲ期非小细胞肺癌(NSCLC)的疗效及放射并发症。

方法

86例Ⅲ期NSCLC患者随机分为A组(n = 42)和B组(n = 44)。A组接受常规放疗,总剂量66至70 Gy,分33至35次,在6至7周内完成;B组在常规放疗40 Gy后行晚期3DCRT,剂量为24 - 30 Gy,分6次(每次400 - 500 cGy,隔日一次),在5至6周内完成。

结果

A组和B组的有效率分别为55.0%和82.9%,完全缓解率分别为7.5%和31.7%,两组间差异有统计学意义(P < 0.05)。A组和B组患者的1年和2年生存率分别为62.5%对78.0%和40.0%对53.7%,差异无统计学意义(P > 0.05)。A组和B组的中位生存时间分别为11.4个月和19.8个月。两组观察到的主要放射并发症为Ⅰ至Ⅱ级急性放射性食管炎和造血系统毒性。两组的晚期放射并发症为Ⅰ至Ⅱ级放射性肺纤维化,发生率相似。

结论

晚期3DCRT治疗Ⅲ期NSCLC患者的疗效优于常规放疗。

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