CAJ | 학술논문

三维适形放疗治疗局部晚期非小细胞肺癌的疗效
삼유괄형방료치료국부만기비소세포폐암적료효
Therapeutic efficacy of three-dimensional conformal radiation therapy for patients with locally advanced non-small cell lung cancer

万方数据

中华肿瘤杂志中華腫瘤雜誌 중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2011年 7期 529-534 ,共6页

曹建忠%欧广飞%梁军%吕纪马%周宗玫%陈东福%肖泽芬%冯勤付%张红星%王绿化%殷蔚伯

조건충%구엄비%량군%려기마%주종매%진동복%초택분%풍근부%장홍성%왕녹화%은위백

癌,非小细胞肺%放射疗法%三维适形放疗%疗效%预后癌,非小細胞肺%放射療法%三維適形放療%療效%預後
암,비소세포폐%방사요법%삼유괄형방료%료효%예후
Carcinoma,non-small cell lung%Radiotherapy%Three dimensional radiation therapy%Therapeutic efficacy%Prognosis

目的评价三维适形放疗治疗局部晚期非小细胞肺癌(NSCLC)的疗效.方法 527例局部晚期NSCLC患者中,253例接受三维适形放疗,274例接受常规放疗.三维适形放疗组中,接受化放综合治疗者159例(62.8%).放射剂量为50～59 Gy者49例, 60 Gy者127例,＞60 Gy者77例.常规放疗组中,接受放化综合治疗者127例(46.4%).放射剂量为50～59 Gy者75例,60 Gy者151例,＞60 Gy者48例.结果三维适形放疗组患者的1、3、5年总生存率分别为73.3%、26.1%和14.4%,中位生存时间为20.1 个月;常规放疗组患者的1、3、5年总生存率分别为61.0%、13.8%和8.0%,中位生存时间为15.6 个月(P=0.002).三维适形放疗组患者的1、3、5年肿瘤专项生存率分别为79.0%、33.3%和20.8%,常规放疗组患者分别为65.1%、16.7%和11.2%(P＜0.001).三维适形放疗组患者的1、3、5年局部区域控制率分别为71.6%、34.3%和31.0%;常规放疗组患者分别为57.3%、22.1%和19.2%(P=0.002).多因素分析结果显示,KPS评分、治疗前血红蛋白、放疗方法和近期疗效是NSCLC患者总生存和肿瘤专项生存的独立影响因素,三维适形放疗组的总生存率和肿瘤专项生存率较常规放疗组显著提高(OR分别为0.762和0.680,均P＜0.01).两组患者放射性食管炎和放射性肺炎的发生率差异无统计学意义(P＞0.05).结论采用三维适形放疗技术,能够提高局部晚期NSCLC患者的生存率.
목적 평개삼유괄형방료치료국부만기비소세포폐암(NSCLC)적료효.방법 527례국부만기NSCLC환자중,253례접수삼유괄형방료,274례접수상규방료.삼유괄형방료조중,접수화방종합치료자159례(62.8%).방사제량위50～59 Gy자49례, 60 Gy자127례,＞60 Gy자77례.상규방료조중,접수방화종합치료자127례(46.4%).방사제량위50～59 Gy자75례,60 Gy자151례,＞60 Gy자48례.결과 삼유괄형방료조환자적1、3、5년총생존솔분별위73.3%、26.1%화14.4%,중위생존시간위20.1 개월;상규방료조환자적1、3、5년총생존솔분별위61.0%、13.8%화8.0%,중위생존시간위15.6 개월(P=0.002).삼유괄형방료조환자적1、3、5년종류전항생존솔분별위79.0%、33.3%화20.8%,상규방료조환자분별위65.1%、16.7%화11.2%(P＜0.001).삼유괄형방료조환자적1、3、5년국부구역공제솔분별위71.6%、34.3%화31.0%;상규방료조환자분별위57.3%、22.1%화19.2%(P=0.002).다인소분석결과현시,KPS평분、치료전혈홍단백、방료방법화근기료효시NSCLC환자총생존화종류전항생존적독립영향인소,삼유괄형방료조적총생존솔화종류전항생존솔교상규방료조현저제고(OR분별위0.762화0.680,균P＜0.01).량조환자방사성식관염화방사성폐염적발생솔차이무통계학의의(P＞0.05).결론 채용삼유괄형방료기술,능구제고국부만기NSCLC환자적생존솔.
Objective 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). Methods 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 ceceived 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. Results 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. Conclusions 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.