摘要
目的探讨常规放疗与适形放疗结合治疗Ⅲ期肺鳞癌的疗效及患者的耐受性.方法自1996年10月至2002年10月对118例Ⅲ期肺鳞癌患者常规放射治疗40～50 Gy(平均44.6 Gy)后的残留病灶再行适形放疗.肿瘤边缘单次处方剂量平均为6.8 Gy,间隔1～2 d,总照射剂量平均为39.4 Gy.肿瘤靶体积(GTV)0.8～148.6 cm3,平均36.6 cm3;计划靶体积(PTV)3.6～213.5 cm3,平均51.4 cm3.结果近期CR率30.5%(36/118),PR率53.4%(63/118),NR率11.9%(14/118),PD率4.2%(5/118),总有效率(CR+PR)83.9%.1,2,3年生存率分别为68.6%(81/118)、35.6%(31/87)和12.2%(6/49),局部控制率分别为92.4%(109/118)、85.1%(74/87)和79.6%(39/49).急性放射性肺炎Ⅰ～Ⅱ级32例,Ⅲ级4例,Ⅳ级0例.晚期放射毒副反应:放射性食管损伤Ⅲ级1例,放射性肺损伤Ⅱ级1例.结论对Ⅲ期肺鳞癌常规放疗后再行适形放疗局部加量照射,患者可耐受,疗程短,可提高肿瘤控制率,延长生存期,是局部剂量升级的有效方法.
Objective To evaluate the efficacy of combination of routine radiotherapy and 3-dimensional conformal radiotherapy （3-DCRT） in treatment of squamous cell cancer of lung at stage Ⅲ and the tolerance of the patients. Methods From Oct. 1996 to Oct. 2002,118 patients with squamous ceil cancer of lung at stage Ⅲ were treated with routine radiotherapy at the total doses of 40-50 Gy（ average 44.6 Gy）, The residues of these tumours were treated with 3-DCRT at single tumour target dose of 6.8 Gy every other or two days and a total dose of 39.4 Gy. The tumour target volume ranged from 0.8 to 148.6 cm3^ , with an average of 36.6 cm^3 . The planned target volume ranged from 3.6 to 213.5 cm^3 , with an average of 51.4 cm^3 . Results The short-term rate of CR was 30.5 % （36/118） ,PR 53.4%（63/118）,NR 11.9%（14/118） and PD 4.2%（5/118）.The response rate （CR＋ PR） was 83.9%. 1-,2-,and 3-year survival rates were 68.6% （81/118）,35.6% （31/87）and 12.2% （6/49）and local control rates were 92.4% （109/118）, 85.1% （74/87） and 79,6% （39/49） respectively, The rates of acute radio-pneumonia were 27.1%（32/118） at grade- Ⅰ -Ⅱ ,3.4%（4/118）at grade Ⅲ and 0（0/118） at grade Ⅳ .The late side effects were the injury of esophagus at grade Ⅲ （1 case） and the injury of lung at grade Ⅱ （ 1 case）. After the squamous ceil carcinoma of lung at stagem was treated with routine radiotherapy, the 3-DCRT could be used. The patients could tolerate this treatment. The period of the treatment was short. The control rate of the disease was raised and the survival time was prolonged, This treatment is the effective method for treating this disease.
出处
《中国肿瘤临床与康复》
2005年第4期358-360,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肺肿瘤/放射疗法
三维适形放疗
Lung neoplasms/radiotherapy
Three dimensional conformal radiotherapy
作者简介
季海涛（1975-），男，黑龙江呼兰人，医师，医学学士，从事肿瘤放疗与治疗研究。
