CAJ | 학술논문

目的观察常规分割放疗基础上后程三维适形大分割放疗并序贯化疗治疗非小细胞肺癌(NSCLC)的疗效.方法 62例符合条件的Ⅲ期NSCLC患者人组.先予NP方案化疗2个周期,化疗结束20余天待WBC恢复正常后开始放射治疗,放射治疗的前半程予前后对穿大野照射,常规分割2 Gy/次,剂量40 Gy,20次,之后针对肺部原发灶及纵隔内≥1 am的转移淋巴结用三维适形放疗技术采用大分割放疗4～6 Gy/次,间隔1～2 d,剂量24～30 Gy,4～6次.锁骨上有淋巴结转移者采用60Co或6MV-X线加电子线常规分割放疗至总量64～66 Gy.放射治疗结束后再追加化疗2个周期.结果 62例患者全部完成治疗计划,随访3年.肺原发灶完全缓解(CR)9例,部分缓解(PR)40例.肿瘤总有效率为79.0%.1、2、3年生存率为71.0%、48.4%、30.6%.1、2、3年局控率为80.6%、62.9%、40.3%.急性不良反应主要有:急性放射性食管炎、气管炎、胃肠道反应以及骨髓抑制,经过对症处理后均能完成治疗.结论在常规分割放疗基础上后程行三维适形大分割放疗并序贯化疗治疗NSCLC有较好的疗效和能为患者接受的不良反应.
목적 관찰상규분할방료기출상후정삼유괄형대분할방료병서관화료치료비소세포폐암(NSCLC)적료효.방법 62례부합조건적Ⅲ기NSCLC환자인조.선여NP방안화료2개주기,화료결속20여천대WBC회복정상후개시방사치료,방사치료적전반정여전후대천대야조사,상규분할2 Gy/차,제량40 Gy,20차,지후침대폐부원발조급종격내≥1 am적전이림파결용삼유괄형방료기술채용대분할방료4～6 Gy/차,간격1～2 d,제량24～30 Gy,4～6차.쇄골상유림파결전이자채용60Co혹6MV-X선가전자선상규분할방료지총량64～66 Gy.방사치료결속후재추가화료2개주기.결과 62례환자전부완성치료계화,수방3년.폐원발조완전완해(CR)9례,부분완해(PR)40례.종류총유효솔위79.0%.1、2、3년생존솔위71.0%、48.4%、30.6%.1、2、3년국공솔위80.6%、62.9%、40.3%.급성불량반응주요유:급성방사성식관염、기관염、위장도반응이급골수억제,경과대증처리후균능완성치료.결론 재상규분할방료기출상후정행삼유괄형대분할방료병서관화료치료NSCLC유교호적료효화능위환자접수적불량반응.
Objective To observe the toxicity and effection of three dimensional conformal radiation therapy(3DCRT)based on conventional fractionation radiotherapy in combination with chemotherapy in non-small-cell lung cancer(NSCLC).Methods 62 NSCLC patients with stage Ⅲ were chosen as research objects.All the patients received chemotherapy two cycles with NP regimen firstly(NVB 40 mg d1,8,DDP 30 mg d2-5),then they accepted radiotherapy in twentith day after chemotherapy when hemocyte got normal.In the first half period of the radiotherapy,conventional radiotherapy were given with 2 Gy/f,after the dose got 40 Gy/20 f,then three dimensional conformal radiation therapy were given with 4～6 Gy/f every 1 to 2 days until the total dose got 24～30 Gy/4～6 f.The patients with supraclavicular lymphnode metastatic carcinoma received conventional fractionation radiotherapy with 60Co or 6 MV-X ray combined electronic ray until the dose(DT)up to 64～66 Gy.After radiotherapy,the patients accepted chemotherapy two cycles with NP regimen again.Results All the 62 patients completed treatment plan,and follow-up survey had lasted for 3 years.The short-term efficacy was evaluated in 3 months after radiotherapy. Among 62 patients, 9 cases gained a complete remission(CR),40 cases partial remission(PR),and the total remission was 79.0%.The acute toxicity showed acute radiation esophagitis,radiation pneumonia and acute gastrointestinal reaction.However,expectant treatment was effective.The 1,2,3 year survival rate was 7 1.0%,48.4%,30.6%,respectively.The 1,2,3 year local control rate was 80.6%,62.9%,40.3%,respectively.Conclusion 3DCRT based on conventional fractionation radiotherapy for NSCLC have good effection and mild toxicity.