中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2009年
1期
52-56
,共5页
付和谊%卢冰%周华宁%欧阳伟炜%苏胜发%胡银祥%甘家应%吴伟莉%栗蕙芹
付和誼%盧冰%週華寧%歐暘偉煒%囌勝髮%鬍銀祥%甘傢應%吳偉莉%慄蕙芹
부화의%로빙%주화저%구양위위%소성발%호은상%감가응%오위리%률혜근
肺肿瘤/化放疗法%肺肿瘤/放射疗法%肺肿瘤/化学疗法%同期化放疗%序贯化放疗%三维适形%后程加速超分割%预后
肺腫瘤/化放療法%肺腫瘤/放射療法%肺腫瘤/化學療法%同期化放療%序貫化放療%三維適形%後程加速超分割%預後
폐종류/화방요법%폐종류/방사요법%폐종류/화학요법%동기화방료%서관화방료%삼유괄형%후정가속초분할%예후
Lung neoplasms/ehemo-radiotherapy%Lung neoplasms/radiotherapy%Lung neo plasms/chemotherapy%Concurrent ehemo-radiotherapy%Sequentially ehemo-radiotherapy%Three-dimensional conformal%Late-course accelerated%Prognosis
目的 研究Ⅳ期非小细胞肺癌(NSCLC)同期化放疗的意义.方法 10年间收治经病理或细胞学诊断的Ⅳ期NSCLC患者300例,可分析病例214例,其中3周方案化疗同期放疗(同期A)98例、每周方案化疗同期放疗(同期B)18例、单纯化疗44例、单纯放疗37例和序贯化放疗17例.原发灶放疗采用常规分割和后程超分割的三维适形和常规放疗技术,肿瘤剂量为36～86 Gy.化疗中3周方案以铂类为基础联合紫杉醇、多西紫杉醇、长春瑞滨、依托泊甙等(21～28 d为1周期),每周方案采用顺铂联合紫杉醇或拓扑替康4-6周.结果 随访率为99%.同期A、同期B、单纯化疗、单纯放疗、序贯化放疗的1和2年生存率分别为41%和11%、16%和0、31%和7%、34%和10%、26%和3%(x2=11.18,P=0.025).分层分析显示同期A中采用三维适形技术、后程加速超分割方式、原发灶剂量≥70 Gy的较单纯化疗显著延长生存率,同期A中接受三维适形+后程加速超分割+≥70 Gy治疗的21例患者生存率显著优于单纯化疗,而且化疗≥2周期同期化放疗者的牛存率也较相同周期的单纯化疗者长.结论 化疗同期采用三维适形、后程加速超分割、≥70 Gy治疗原发病灶并对转移灶进行放疗可显著延长Ⅳ期NSCLC的生存期.
目的 研究Ⅳ期非小細胞肺癌(NSCLC)同期化放療的意義.方法 10年間收治經病理或細胞學診斷的Ⅳ期NSCLC患者300例,可分析病例214例,其中3週方案化療同期放療(同期A)98例、每週方案化療同期放療(同期B)18例、單純化療44例、單純放療37例和序貫化放療17例.原髮竈放療採用常規分割和後程超分割的三維適形和常規放療技術,腫瘤劑量為36～86 Gy.化療中3週方案以鉑類為基礎聯閤紫杉醇、多西紫杉醇、長春瑞濱、依託泊甙等(21～28 d為1週期),每週方案採用順鉑聯閤紫杉醇或拓撲替康4-6週.結果 隨訪率為99%.同期A、同期B、單純化療、單純放療、序貫化放療的1和2年生存率分彆為41%和11%、16%和0、31%和7%、34%和10%、26%和3%(x2=11.18,P=0.025).分層分析顯示同期A中採用三維適形技術、後程加速超分割方式、原髮竈劑量≥70 Gy的較單純化療顯著延長生存率,同期A中接受三維適形+後程加速超分割+≥70 Gy治療的21例患者生存率顯著優于單純化療,而且化療≥2週期同期化放療者的牛存率也較相同週期的單純化療者長.結論 化療同期採用三維適形、後程加速超分割、≥70 Gy治療原髮病竈併對轉移竈進行放療可顯著延長Ⅳ期NSCLC的生存期.
목적 연구Ⅳ기비소세포폐암(NSCLC)동기화방료적의의.방법 10년간수치경병리혹세포학진단적Ⅳ기NSCLC환자300례,가분석병례214례,기중3주방안화료동기방료(동기A)98례、매주방안화료동기방료(동기B)18례、단순화료44례、단순방료37례화서관화방료17례.원발조방료채용상규분할화후정초분할적삼유괄형화상규방료기술,종류제량위36～86 Gy.화료중3주방안이박류위기출연합자삼순、다서자삼순、장춘서빈、의탁박대등(21～28 d위1주기),매주방안채용순박연합자삼순혹탁복체강4-6주.결과 수방솔위99%.동기A、동기B、단순화료、단순방료、서관화방료적1화2년생존솔분별위41%화11%、16%화0、31%화7%、34%화10%、26%화3%(x2=11.18,P=0.025).분층분석현시동기A중채용삼유괄형기술、후정가속초분할방식、원발조제량≥70 Gy적교단순화료현저연장생존솔,동기A중접수삼유괄형+후정가속초분할+≥70 Gy치료적21례환자생존솔현저우우단순화료,이차화료≥2주기동기화방료자적우존솔야교상동주기적단순화료자장.결론 화료동기채용삼유괄형、후정가속초분할、≥70 Gy치료원발병조병대전이조진행방료가현저연장Ⅳ기NSCLC적생존기.
Objective To analyze the clinical outcome of concurrent ehemo-radiotherapy in stage Ⅳ non-small cell lung cancer(NSCLC).Methods From Jan.1997 to Dec.2006,214 patients with patho logically or cytologically proven stage Ⅳ NSCLC were included in this analysis.Of those patients,98 re ceived radiotherapy concurrently with 3-week cycle chemotherapy(group A),18 received radiotherapy con currently with weekly chemotherapy(group B) ,44 received chemotherapy alone,37 received radiotherapy a lone and 13 received sequential chemo-radiotherapy.The primary tumor was treated by three-dimensional conformal radiotherapy(3DCRT) or conventional radiotherapy with conventional fraefionation or late-course accelerated hyperfraction (LA H RT).Group A received 21-28 days cycle cisplatin-based chemotherapy (cis platin combined with PTX,DTY,NVB or Vp-16) ,and group B received weekly DDP combined with PTX or topteeon for 4-6 weeks.Results The follow-up rate was 99%.The 1-and 2-year overall survival rates of group A,group B,chemotherapy alone,radiotherapy alone and sequential chemo-radiotherapy were 41% and 11% ,16% and 0,31% and 7% ,34% and 10% ,26% and 3% ,respectively(x2 = 11.18,P=0.025).The patients with concurrent 3DCRT,LAHRT and radiotherapy dose≥70 Gy had better survival in group A than those in chemotherapy alone group.Patients who received≥2 cycles chemotherapy with concurrent radio therapy had longer survival time than those who had ≥2 cycles chemotherapy alone. Conclusions Con current chemotherapy and 3DCRT,LAHRT with the dose ≥70 Gy can improve the overall survival of patients with stage Ⅳ non-small cell lung cancer.
