中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2013年
16期
992-996
,共5页
放射性粒子%近距离放疗%同步放化疗%非小细胞肺癌
放射性粒子%近距離放療%同步放化療%非小細胞肺癌
방사성입자%근거리방료%동보방화료%비소세포폐암
radioactive seeds%interstitial brachytherapy%concurrent radiotherapy and chemotherapy%non-small cell lung cancer
目的：评价放射性粒子组织间近距离放疗联合EP方案同步放化疗治疗局部晚期非小细胞肺癌的疗效及不良反应。方法：选择2008年1月至2011年5月自愿在内蒙古医科大学附属医院放疗科接受同步放化疗的24例局部晚期非小细胞肺癌患者，接受三维适形调强放疗6MV-X线95%PTV60～66Gy/30～33F，每周放疗5次。同步给予化疗（EP方案），VP-16，60 mg/m2静脉滴注1～5 d，DDP 50 mg/m2静脉滴注1、8 d，28 d为1个周期，放疗期间同步2个周期，共4个周期，其余周期在放疗后继续治疗。同步放化疗结束3个月复查，对于3个月复查PET-CT证实肿瘤残存病灶给予放射性125I粒子植入，行组织间近距离放疗，以补充剂量。结果：近期有效率83.3%（20/24）；术后3、6、9、12、18、24个月局控制率分别为87.5%（21/24）、83.3%（20/24）、75.0%（18/24）、70.8%（17/24）、58.3%（14/24）、50.0%（12/24）。中位生存期20.2个月，1年生存率62.5%，2年生存率37.5%。主要不良反应：放射性肺损伤发生率25%，放射性食管炎发生率33.3%；消化道反应为Ⅰ～Ⅱ级82.3%，粒细胞降低发生率87.5%，其中Ⅰ～Ⅱ级75.0%，Ⅲ级12.5%，无Ⅳ级反应。结论：EP方案同步放化疗联合放射性粒子组织间近距离放治疗局部晚期非小细胞肺癌，疗效肯定，严重不良反应较少，值得临床推广。
目的：評價放射性粒子組織間近距離放療聯閤EP方案同步放化療治療跼部晚期非小細胞肺癌的療效及不良反應。方法：選擇2008年1月至2011年5月自願在內矇古醫科大學附屬醫院放療科接受同步放化療的24例跼部晚期非小細胞肺癌患者，接受三維適形調彊放療6MV-X線95%PTV60～66Gy/30～33F，每週放療5次。同步給予化療（EP方案），VP-16，60 mg/m2靜脈滴註1～5 d，DDP 50 mg/m2靜脈滴註1、8 d，28 d為1箇週期，放療期間同步2箇週期，共4箇週期，其餘週期在放療後繼續治療。同步放化療結束3箇月複查，對于3箇月複查PET-CT證實腫瘤殘存病竈給予放射性125I粒子植入，行組織間近距離放療，以補充劑量。結果：近期有效率83.3%（20/24）；術後3、6、9、12、18、24箇月跼控製率分彆為87.5%（21/24）、83.3%（20/24）、75.0%（18/24）、70.8%（17/24）、58.3%（14/24）、50.0%（12/24）。中位生存期20.2箇月，1年生存率62.5%，2年生存率37.5%。主要不良反應：放射性肺損傷髮生率25%，放射性食管炎髮生率33.3%；消化道反應為Ⅰ～Ⅱ級82.3%，粒細胞降低髮生率87.5%，其中Ⅰ～Ⅱ級75.0%，Ⅲ級12.5%，無Ⅳ級反應。結論：EP方案同步放化療聯閤放射性粒子組織間近距離放治療跼部晚期非小細胞肺癌，療效肯定，嚴重不良反應較少，值得臨床推廣。
목적：평개방사성입자조직간근거리방료연합EP방안동보방화료치료국부만기비소세포폐암적료효급불량반응。방법：선택2008년1월지2011년5월자원재내몽고의과대학부속의원방료과접수동보방화료적24례국부만기비소세포폐암환자，접수삼유괄형조강방료6MV-X선95%PTV60～66Gy/30～33F，매주방료5차。동보급여화료（EP방안），VP-16，60 mg/m2정맥적주1～5 d，DDP 50 mg/m2정맥적주1、8 d，28 d위1개주기，방료기간동보2개주기，공4개주기，기여주기재방료후계속치료。동보방화료결속3개월복사，대우3개월복사PET-CT증실종류잔존병조급여방사성125I입자식입，행조직간근거리방료，이보충제량。결과：근기유효솔83.3%（20/24）；술후3、6、9、12、18、24개월국공제솔분별위87.5%（21/24）、83.3%（20/24）、75.0%（18/24）、70.8%（17/24）、58.3%（14/24）、50.0%（12/24）。중위생존기20.2개월，1년생존솔62.5%，2년생존솔37.5%。주요불량반응：방사성폐손상발생솔25%，방사성식관염발생솔33.3%；소화도반응위Ⅰ～Ⅱ급82.3%，립세포강저발생솔87.5%，기중Ⅰ～Ⅱ급75.0%，Ⅲ급12.5%，무Ⅳ급반응。결론：EP방안동보방화료연합방사성입자조직간근거리방치료국부만기비소세포폐암，료효긍정，엄중불량반응교소，치득림상추엄。
Objective: To evaluate the clinical effect and adverse reactions of radioactive seed interstitial brachytherapy com-bined with etoposide (EP) regimen concurrent chemoradiotherapy treatment for locally advanced non-small cell lung cancer. Methods:All 24 cases of locally advanced non-small cell lung cancer received three-dimensional conformal intensity modulated radiation therapy by using 6 MV X-ray to obtain 95%60-66 Gy/30-33 F planning target volume. All cases received radiation therapy five times a week. EP regimen chemotherapy concurrent with radiotherapy was given to 24 patients. The therapy included VP-16, 60 mg/m2 intravenous in-fusion for 1 d to 5 d, and DDP 50 mg/m2 intravenous infusion on the 1st, 8th, and 28th therapy day. Chemotherapy with EP regimen was given for four cycles, in which two cycles were given during radiotherapy and the remaining cycles were completed after radiotherapy. The patients were reexamined three months after concurrent chemoradiotherapy was completed. Patients with residual tumor, con-firmed via positron emission tomography/computed tomography, underwent 125I radioactive seed implantation interstitial brachytherapy to complement the dose of tumor. Results: The response rate was 83.3% (20/24); the local control rates of 3, 6, 9, 12, 18, and 24 months were 87.5% (21/24), 83.3% (20/24), 75.0% (18/24), 70.8% (17/24), 58.3% (14/24), and 50.0% (12/24). The median survival was 20.2 months. The one-year survival rate was 62.5%, and the two-year survival rate was 37.5%. The following main toxicities were observed:the incidence of radiation-induced lung injury was 25%;the incidence of radiation esophagitis was 33.3%;the incidence of grades Ⅰ to Ⅱ gastrointestinal reactions was 82.3%; the incidence of reducing neutropenia was 87.5%, in which the incidence of gradesⅠtoⅡwas 75.0%, gradeⅢwas 12.5%, and gradeⅣwas 0%. Conclusion:EP regimen concurrent radiotherapy and chemo-therapy combined with radioactive seed interstitial brachytherapy for locally advanced non-small cell lung cancer is effective and has few serious adverse reactions, thus making this approach worthy of promotion.
