中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2010年
6期
496-499
,共4页
夏冰%陈桂园%蔡旭伟%赵建东%杨焕军%樊旼%赵快乐%傅小龙
夏冰%陳桂園%蔡旭偉%趙建東%楊煥軍%樊旼%趙快樂%傅小龍
하빙%진계완%채욱위%조건동%양환군%번민%조쾌악%부소룡
癌,小细胞肺/放射疗法%剂量分割模式%治疗结果
癌,小細胞肺/放射療法%劑量分割模式%治療結果
암,소세포폐/방사요법%제량분할모식%치료결과
Carcinoma,small cell lung/radiotherapy%Dose fractionation%Treatment outcome
目的 比较不同剂最分割模式放疗对局限期小细胞肺癌生存的影响.方法 回顾分析本院2001-2007年收治的177例局限期小细胞肺癌患者资料.入组条件为病理学证实、局限期且接受了根治性放化疗的患者.根据剂量分割模式将患者分为常规分割组(1.8~2.0 Gy/次,1次/d,63例)、超分割组(1.4 Gy/次,2次/d,79例)和大分割组(2.5 Gy/次,1次/d,35例).对3个组的总生存率、无进展生存率和治疗失败模式进行统计分析.结果 随访率为96.6%,随访满2、5年者分别为153、92例.全组2、5年总生存率分别为43.4%、23.5%,中位生存期为22.4个月.常规分割组、超分割组、大分割组的2年总生存率和无进展生存率分别为31%、46%、59%(x2=7.94,P=0.019)和20%、31%、40%(x2=4.86,P=0.088),两两比较发现2年总生存率大分割组优于常规分割组(x2=7.81,P=0.005),超分割组介于两组之间但差别均无统计学意义(x2=2.31,P=0.128;x2=2.95,P=0.086).毒副反应以大分割组最轻,局部进展与远处转移分布3个组相似.结论 大分割放疗局限期小细胞肺癌显示了一定生存优势,有必要前瞻性临床研究验证其临床价值.
目的 比較不同劑最分割模式放療對跼限期小細胞肺癌生存的影響.方法 迴顧分析本院2001-2007年收治的177例跼限期小細胞肺癌患者資料.入組條件為病理學證實、跼限期且接受瞭根治性放化療的患者.根據劑量分割模式將患者分為常規分割組(1.8~2.0 Gy/次,1次/d,63例)、超分割組(1.4 Gy/次,2次/d,79例)和大分割組(2.5 Gy/次,1次/d,35例).對3箇組的總生存率、無進展生存率和治療失敗模式進行統計分析.結果 隨訪率為96.6%,隨訪滿2、5年者分彆為153、92例.全組2、5年總生存率分彆為43.4%、23.5%,中位生存期為22.4箇月.常規分割組、超分割組、大分割組的2年總生存率和無進展生存率分彆為31%、46%、59%(x2=7.94,P=0.019)和20%、31%、40%(x2=4.86,P=0.088),兩兩比較髮現2年總生存率大分割組優于常規分割組(x2=7.81,P=0.005),超分割組介于兩組之間但差彆均無統計學意義(x2=2.31,P=0.128;x2=2.95,P=0.086).毒副反應以大分割組最輕,跼部進展與遠處轉移分佈3箇組相似.結論 大分割放療跼限期小細胞肺癌顯示瞭一定生存優勢,有必要前瞻性臨床研究驗證其臨床價值.
목적 비교불동제최분할모식방료대국한기소세포폐암생존적영향.방법 회고분석본원2001-2007년수치적177례국한기소세포폐암환자자료.입조조건위병이학증실、국한기차접수료근치성방화료적환자.근거제량분할모식장환자분위상규분할조(1.8~2.0 Gy/차,1차/d,63례)、초분할조(1.4 Gy/차,2차/d,79례)화대분할조(2.5 Gy/차,1차/d,35례).대3개조적총생존솔、무진전생존솔화치료실패모식진행통계분석.결과 수방솔위96.6%,수방만2、5년자분별위153、92례.전조2、5년총생존솔분별위43.4%、23.5%,중위생존기위22.4개월.상규분할조、초분할조、대분할조적2년총생존솔화무진전생존솔분별위31%、46%、59%(x2=7.94,P=0.019)화20%、31%、40%(x2=4.86,P=0.088),량량비교발현2년총생존솔대분할조우우상규분할조(x2=7.81,P=0.005),초분할조개우량조지간단차별균무통계학의의(x2=2.31,P=0.128;x2=2.95,P=0.086).독부반응이대분할조최경,국부진전여원처전이분포3개조상사.결론 대분할방료국한기소세포폐암현시료일정생존우세,유필요전첨성림상연구험증기림상개치.
Objective To study the effect of different dose fractionation on overall survival in patients with limited-stage small cell lung cancer (LS-SCLC). Methods LS-SCLC patients treated with
radical combined chemotherapy and radiotherapy (RT) between January 2001 and Dec 2007 were analyzed retrospectively. According to the dose fractionation schemes, patients were divided into three groups:conventional fractionated RT (1. 8 -2.0 Gy,once daily), hyperfractionated RT (1.4 Gy, twice daily) and hypofractionated RT (2. 5 Gy,once daily). Overall survival, disease free survival and pattern of failures of the three groups were compared. A total of 177 patients were enrolled, including 63 patients in conventional fractionated RT group, 79 in hyperfractionated RT group and 35 in hypofractionated RT group. Results The overall follow-up rate was 96. 6%. The patient numbers with follow-up of more than 2 and 5 years were
153 and 92, respectively. The median survival time of the entire group was 22. 4 months, and the 2-and 5-year survival rates were 43.4% and 23. 5%, respectively. The 2-year survival rates for three groups were 31%, 46% and 59% (x2 =7.94,P=0.019), respectively. The 2-year disease free survival for three
groups were 20%, 31% and 40% ( x2 = 4. 86, P = 0. 088 ), respectively. In the pairwise comparisons,patients in hypofractionated RT group have better survival than those in conventional fractionated RT group ( x2 = 7. 81, P = 0. 005 ), the effect of hyperfractionated RT group lies between the hypo-and the conventional fractionated RT groups, but no significant differences were detected ( x2 = 2. 31, P = 0. 128; x2 = 2. 95, P =0. 086). The mildest side effect was found in the hypofractionated RT group. No statistically significant differences were found in the patterns of first failure. Conclusion The hypofractionated RT scheme showed potential survival benefits for patients with LS-SCLC and should be considered in the setting of randomized clinical trials.