CAJ | 학술논문

目的：评估同步加量放疗技术在非小细胞肺癌（non-small cell lung cancer，NSCLC）脑转移应用中的临床疗效、不良反应、生存时间，探索该技术的可行性。方法：76例NSCLC脑转移患者以不同分割模式分为A组（42例）和B组（34例）。A组患者全脑放疗DT 40Gy/（20f·4周）后局部推量DT 20Gy/（10f·2周），B组患者全脑放疗DT 36Gy/（20f·4周）全程同步加量适形放疗DT 24Gy/（20f·4周）。比较两组放疗疗效、不良反应、半年、1年总生存率。结果：采用 RECIST 1．1标准，A组放疗有效率为95．2％（40/42），B组有效率为97．1％（33/34），两组疗效未见统计学差异。A、B两组患者在血液毒性、神经系统受损、消化道反应、脱发等方面均未见明显异常。A组中位生存时间为8．94个月，患者半年、1年生存率为71．4％、35．7％；B组患者中位生存时间为9．47个月，半年、1年生存率为82．4％、38．2％，两组无统计学差异。结论：两种分割模式在临床疗效、不良反应、生存时间方面疗效相当。全脑照射全程同步加量治疗脑转移近期疗效确切，患者耐受性很好，可缩短放疗时间。
목적：평고동보가량방료기술재비소세포폐암（non-small cell lung cancer，NSCLC）뇌전이응용중적림상료효、불량반응、생존시간，탐색해기술적가행성。방법：76례NSCLC뇌전이환자이불동분할모식분위A조（42례）화B조（34례）。A조환자전뇌방료DT 40Gy/（20f·4주）후국부추량DT 20Gy/（10f·2주），B조환자전뇌방료DT 36Gy/（20f·4주）전정동보가량괄형방료DT 24Gy/（20f·4주）。비교량조방료료효、불량반응、반년、1년총생존솔。결과：채용 RECIST 1．1표준，A조방료유효솔위95．2％（40/42），B조유효솔위97．1％（33/34），량조료효미견통계학차이。A、B량조환자재혈액독성、신경계통수손、소화도반응、탈발등방면균미견명현이상。A조중위생존시간위8．94개월，환자반년、1년생존솔위71．4％、35．7％；B조환자중위생존시간위9．47개월，반년、1년생존솔위82．4％、38．2％，량조무통계학차이。결론：량충분할모식재림상료효、불량반응、생존시간방면료효상당。전뇌조사전정동보가량치료뇌전이근기료효학절，환자내수성흔호，가축단방료시간。
Objective:To observe the local control rate,survival rate and side effects of the patients with brain me-tastases by whole brain radiotherapy (WBRT)with local simultaneous integrated boost conformal radiotherapy (SIB-CR).Methods:Seventy-six patients with brain metastasis of NSCLC were randomly divided into group A (n=42) and group B (n=34).Group A received 40Gy whole brain radiation in 20 fractions over four weeks followed by 20Gy focal radiation in 10 fractions over two weeks.Group B received 36Gy whole brain radiation in 20 fractions over four weeks with simultaneous integrated boost by 24Gy focal radiation in 20 fractions.Therapeutic effect,adverse reac-tions and survival time were evaluated.Results:Using RECIST 1 .1 treatment response evaluation criteria,the clinical symptom remission rate was 95.2%(40/42)in group A,97.1%(33/34)in group B.There was no significantly difference between group A and group B.There was no significantly difference in hematological toxicity,gastrointes-tional reaction,nervous system damage and alopecia in two groups.The median survival time,six months and 1 -year survival rates of the patients in group A were 8.94 months,71.4% and 35.7%,respectively showing no significant differences to group B were 9.47 months,82.4% and 38.2%,respectively.There was no significantly difference be-tween group A and group B in remission rate,toxic reaction and survival time.Conclusion:Whole brain irradiation with simultaneous integrated boost conformal radiotherapy technique is effective in patients with brain metastases with shorter the total radiotherapy duration and can be well tolerated.