Brachytherapy Department, Greater Poland Cancer Centre, Poznań, Poland.
Radiother Oncol. 2009 Dec;93(3):436-40. doi: 10.1016/j.radonc.2009.09.005. Epub 2009 Oct 23.
The aim of this work is to compare the results of various treatment protocols used in palliative HDRBT with the view of analyzing differences in survival and diminishing breathing difficulties.
A total of 648 patients with advanced lung cancer were divided into two groups according to their clinical stage and the Zubrod-ECOG-WHO score. 303 (46.8%) patients received a total dose of 22.5 Gy in 3 fractions once a week, and 345 (53.2%) patients received a single fraction of 10 Gy. They were under clinical and endobronchial observation taking into consideration survival rates, local remission and duration of symptom relief such as dyspnoea, breathing, cough and haemoptysis.
There was no difference in the length of survival time between the two groups of patients (log-rank test, p=0.055). Patients showing improvement (objective response) survived longer than those who showed no change or progression (F Cox, p=0.000001). In multivariate analysis the other statistically important prognostic factors were: clinical stage of primary tumor (F Cox, p=0.000002), Zubrod-ECOG-WHO score (F Cox, p=0.002) and age of patients (F Cox, p=0.004).
The two treatment protocols showed similar efficiency in overcoming difficulties in breathing. Prognostic factors that significantly correlated with survival length were: grade of remission after treatment, clinical stage and performance status.
本研究旨在比较不同姑息性 HDRBT 治疗方案的结果，分析其在生存和呼吸困难缓解方面的差异。
共纳入 648 例晚期肺癌患者，根据临床分期和 Zubrod-ECOG-WHO 评分将其分为两组。其中 303 例（46.8%）患者接受总剂量 22.5 Gy，分 3 次，每周 1 次；345 例（53.2%）患者接受单次 10 Gy 照射。观察两组患者的生存率、局部缓解率和呼吸困难、呼吸、咳嗽、咯血等症状缓解持续时间，并进行临床和支气管内观察。
两组患者的生存时间无差异（对数秩检验，p=0.055）。有客观缓解的患者生存时间长于无变化或进展的患者（F Cox，p=0.000001）。多因素分析中其他具有统计学意义的预后因素包括：原发肿瘤的临床分期（F Cox，p=0.000002）、Zubrod-ECOG-WHO 评分（F Cox，p=0.002）和患者年龄（F Cox，p=0.004）。
两种治疗方案在缓解呼吸困难方面均具有相似的疗效。与生存时间显著相关的预后因素包括：治疗后缓解程度、临床分期和体能状态。
