摘要
目的：探讨Ⅲ期非小细胞肺癌调强放疗省略临床靶区（clinical target volume,CTV）外扩区域的可行性。方法 ：回顾性分析2008年1月—2012年11月在北京大学肿瘤医院放疗科接受调强放疗的Ⅲ期非小细胞肺癌患者105例,其中鳞癌73例,腺癌32例。不勾画临床靶区（clinical target volume,CTV）组的患者55例,勾画CTV组的患者50例。肿瘤放疗剂量均为95%PTV 54~63 Gy/27~35fx,放疗5.4~7.0周。结果 ：不勾画CTV组与勾画CTV组的局部复发率分别为32.7%和32.0%,远处转移率分别为56.4%和48.0%（P〉0.05）。两组的中位无进展生存期均为9个月。不勾画CTV组的1、2和3年总生存率分别为74.5%、43.6%和23.6%,勾画CTV组的1、2和3年总生存率分别为70.0%、46.0%和20.0%,差异均无统计学意义（P〉0.05）。不勾画CTV组与勾画CTV组的1~2级放射性肺炎发生率分别为94.5%（52/55）和82.0%（41/50）,3~4级放射性肺炎发生率分别为5.5%（3/55）和18.0%（9/50）,差异有统计学意义（P=0.044）。结论 ：Ⅲ期非小细胞肺癌调强放疗省略CTV外扩区域未增加局部复发率及远处转移率,也未降低无进展生存率及总生存率,但明显降低了3~4级放射性肺炎发生率。
Objective： To analyze the feasibility of omitting clinical target volume（CTV） for patients with stage Ⅲ non-small cell lung cancer（NSCLC） treated with intensity-modulated radiotherapy（IMRT）.Methods： Data of 105 patients with stage Ⅲ NSCLC who were hospitalized and received IMRT in Department of Radiotherapy of Peking University Cancer Hospital from January 2008 to November 2012 were retrospectively analyzed. There were 73 cases of squamous cell carcinoma and 32 cases of adenocarcinoma. Of 105 cases, 55 were irradiated with target volume without CTV, and 50 cases were irradiated with CTV. Dose prescription was 95% planning target volume（PTV） 54-63 Gy/27-35 fx/5.4-7.0 weeks.Results： In the arm without CTV and arm with CTV, the local relapse rates were 32.7% and 32.0%, and the distant metastasis rates were 56.4% and 48.0%, respectively（P 〉 0.05）. The median progression-free survival was 9 months in both groups. The 1-year, 2-year and 3-year survival rates in irradiation with target volume without CTV group were 74.5%, 43.6% and 23.6%, respectively; which were 70.0%, 46.0% and 20.0%, respectively in irradiation with target volume with CTV group（all P 〉 0.05）. The grades 1-2 radiation pneumonia rates in irradiation with target volume without CTV group and with CTV group were 94.5%（52/55） and 82.0%（41/50）, respectively, and the grades 3-4 radiation pneumonia rates were 5.5%（3/55） and 18.0%（9/50）, respectively（P = 0.044）.Conclusion： Omitting CTV for patients with stage Ⅲ NSCLC treated with IMRT can not increase the rates of local recurrence and distant metastasis, and not decrease the progressionfree survival and overall survival, but obviously decrease the rate of grades 3-4 radiation pneumonia.
出处
《肿瘤》
CAS
CSCD
北大核心
2015年第6期675-682,共8页
Tumor
关键词
癌
非小细胞肺
放射疗法
调强放疗
临床靶体积
放射性肺炎
Carcinoma,non-small cell lung
Radiotherapy
Intensity-modulated radiotherapy
Clinical target volume
Radiation pneumonia
作者简介
Correspondence to： ZHU Guang-ying E-mail： zgypu@aliyun.com
