Cao Jian-zhong, Ou Guang-fei, Liang Jun, Lü Ji-ma, Zhou Zong-mei, Chen Dong-fu, Xiao Ze-fen, Feng Qin-fu, Zhang Hong-xing, Wang Lü-hua, Yin Wei-bo
Department of Radiation Oncology, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Zhong Liu Za Zhi. 2011 Jul;33(7):529-34.
To compare the treatment results of three-dimensional conformal radiotherapy (3D-CRT) and conventional radiotherapy (2D) for patients with locally advanced non-small-cell lung cancer (NSCLC).
Five hundred and twenty seven patients with stage III NSCLC treated between Jan 2000 and Dec 2006 were included in this study. Among them, 253 cases were treated with 3D-CRT, and 274 with conventional radiotherapy. In the 3D group, 159 (62.8%) patients received chemoradiotherapy, 77 with total radiotherapy dose of > 60 Gy, 49 with 50 - 60 Gy. In the 2D group, 127 (46.4%) patients received chemoradiotherapy, 48 with total radiotherapy dose of > 60 Gy, 75 with 50 - 60 Gy.
The 1-, 3-, 5-year overall survival rates (OS) and median survival time for patients treated with 3D-CRT were 73.3%, 26.1%, 14.4% and 20.1 months, respectively, and that of patients treated with 2D radiotherapy were 61.0%, 13.8%, 8.0% and 15.6 months, respectively (P = 0.002). The 1-, 3-, 5-year cause-specific survival rates (CSS) were 79.0%, 33.3%, and 20.8% for the 3D group and 65.1%, 16.7%, 11.2%, respectively, for the 2D group (P = 0.000). The 1-, 3-, and 5-year locoregional control rates were 71.6%, 34.3% and 31.0% for patients treated with 3D radiotherapy and 57.3%, 22.1% and 19.2%, respectively, for patients treated with 2D treatment (P = 0.002). The results of multivariate analysis showed that 3D-CRT, KPS, clinical tumor response and pretreatment hemoglobin level were independently associated with increased OS and CSS. No statistically significant differences were found between the radiation complications in the two groups.
The results of our study demonstrate that 3D-conformal radiotherapy improves the survival rate in patients with stage III NSCLC compared with that of 2D radiation therapy.
比较三维适形放疗（3D-CRT）与传统放疗（2D）治疗局部晚期非小细胞肺癌（NSCLC）患者的疗效。
本研究纳入了2000年1月至2006年12月期间接受治疗的527例Ⅲ期NSCLC患者。其中，253例接受3D-CRT治疗，274例接受传统放疗。在3D组中，159例（62.8%）患者接受了同步放化疗，77例总放疗剂量>60 Gy，49例为50 - 60 Gy。在2D组中，127例（46.4%）患者接受了同步放化疗，48例总放疗剂量>60 Gy，75例为50 - 60 Gy。
3D-CRT治疗患者的1年、3年、5年总生存率（OS）及中位生存时间分别为73.3%、26.1%、14.4%和20.1个月，2D放疗治疗患者分别为61.0%、13.8%、8.0%和15.6个月（P = 0.002）。3D组的1年、3年、5年病因特异性生存率（CSS）分别为79.0%、33.3%和20.8%，2D组分别为65.1%、16.7%、11.2%（P = 0.000）。3D放疗治疗患者的1年、3年和5年局部区域控制率分别为71.6%、34.3%和31.0%，2D治疗患者分别为57.3%、22.1%和19.2%（P = 0.002）。多因素分析结果显示，3D-CRT、KPS、临床肿瘤反应和治疗前血红蛋白水平与OS和CSS的提高独立相关。两组放疗并发症之间未发现统计学显著差异。
我们的研究结果表明，与2D放疗相比，三维适形放疗可提高Ⅲ期NSCLC患者的生存率。
