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高剂量放疗对肺癌姑息治疗患者有益吗?:两种剂量方案的科室内比较。

Does high-dose radiotherapy benefit palliative lung cancer patients?: An intradepartmental comparison of two dose regimens.

机构信息

Klinik für Strahlentherapie und Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin, Germany.

出版信息

Strahlenther Onkol. 2013 Sep;189(9):771-6. doi: 10.1007/s00066-013-0360-z. Epub 2013 May 31.

Abstract

BACKGROUND AND PURPOSE

The present analysis compares two palliative treatment concepts for lung cancer in terms of overall survival.

PATIENTS AND METHODS

Survival data from 207 patients were used in a retrospective analysis. All patients received palliative treatment comprising either 25 Gy applied in 5 fractions or 50 Gy in 20 fractions. A subgroup analysis was performed to compare patients with a good-fair vs. poor overall condition.

RESULTS

Median survival times were 21 weeks (range 6-26 weeks) for patients treated with 25 Gy in 5 fractions and 23 weeks (range 14.5-31.5 weeks) for patients treated with 50 Gy in 20 fractions (95 % confidence interval, CI; p = 0.334). For patients with a good-fair overall condition, median survival times were 30 weeks (21.8-39.2 weeks) for 25 Gy in 5 fractions and 28 weeks (14.2-41.8 weeks) for 50 Gy in 20 fractions (CI 95 %, p = 0.694). In patients with a poor overall condition, these values were 18 weeks (14.5-21.5 weeks) and 21 weeks (13.0-29.0 weeks), respectively (CI 95 %, p = 0.248).

CONCLUSION

The palliative treatment concept of 25 Gy applied in 5 fractions is sufficient for radiation of lung cancer, given that there was no obvious survival improvement in patients treated with the higher total dose regimen.

摘要

背景与目的

本分析比较了两种肺癌姑息治疗方案的总生存情况。

患者与方法

回顾性分析了 207 例患者的生存数据。所有患者均接受姑息治疗,包括 25Gy 分 5 次给予或 50Gy 分 20 次给予。进行了亚组分析,以比较总体状况良好/中等与较差的患者。

结果

25Gy 分 5 次给予的患者中位生存时间为 21 周(6-26 周),50Gy 分 20 次给予的患者中位生存时间为 23 周(14.5-31.5 周)(95%置信区间,CI;p=0.334)。对于总体状况良好/中等的患者,25Gy 分 5 次给予的患者中位生存时间为 30 周(21.8-39.2 周),50Gy 分 20 次给予的患者中位生存时间为 28 周(14.2-41.8 周)(95%CI,p=0.694)。对于总体状况较差的患者,这些值分别为 18 周(14.5-21.5 周)和 21 周(13.0-29.0 周)(95%CI,p=0.248)。

结论

对于肺癌的放射治疗,25Gy 分 5 次给予的姑息治疗方案已足够,因为接受更高总剂量方案治疗的患者并未明显改善生存。

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