Brodin O, Rikner G, Steinholtz L, Nou E
Department of Oncology, Uppsala University, Sweden.
Acta Oncol. 1990;29(6):739-46. doi: 10.3109/02841869009092993.
Fifty-three patients with small cell carcinoma of the lung were treated with chemotherapy and radiotherapy, 40 Gy in the chest tumour. Intrathoracic failure occurred in 89% of the cases with extensive disease and in 60% of those with limited disease. Since 86% of all failures were localized within the target volume, one can conclude that in most cases the radiation dose was too low for eradication of the tumour. The treatment technique resulted in dose inhomogeneities of more than +/- 5% in 45% of the cases. The high local failure rate might indicate the need of improved radiotherapy, in the first place higher radiation dose. However, 82% of the patients with limited disease and local failure and 50% of those without local failure also developed distant metastases. This might indicate that the curative potential of improved thoracic radiotherapy probably is limited. Besides, lethal treatment toxicity affected particularly patients in whom local cure had been achieved, indicating the difficulty of increasing the treatment intensity without increasing the lethal toxicity in potentially curable cases.
53例肺小细胞癌患者接受了化疗和放疗，胸部肿瘤放疗剂量为40 Gy。广泛期疾病患者的胸内失败率为89%，局限期疾病患者的胸内失败率为60%。由于所有失败病例的86%局限于靶体积内，因此可以得出结论，在大多数情况下，放疗剂量过低，无法根除肿瘤。治疗技术导致45%的病例剂量不均匀性超过±5%。高局部失败率可能表明需要改进放疗，首先是提高放疗剂量。然而，局限期疾病且有局部失败的患者中有82%以及无局部失败的患者中有50%也发生了远处转移。这可能表明改进胸部放疗的治愈潜力可能有限。此外，致命的治疗毒性尤其影响到已实现局部治愈的患者，这表明在潜在可治愈的病例中，在不增加致命毒性的情况下提高治疗强度存在困难。
