临床医药实践
臨床醫藥實踐
림상의약실천
Proceeding of Clinical Medicine
2015年
11期
805-808
,共4页
林育毅%陈万泉%张纬建%洪芙蓉%卢开贤%邹喜
林育毅%陳萬泉%張緯建%洪芙蓉%盧開賢%鄒喜
림육의%진만천%장위건%홍부용%로개현%추희
非小细胞肺癌%脑转移%放射治疗%全脑放疗%调强放射治疗
非小細胞肺癌%腦轉移%放射治療%全腦放療%調彊放射治療
비소세포폐암%뇌전이%방사치료%전뇌방료%조강방사치료
lung neoplasms%brain metastasis%radiotherapy%whole - brain irradiation therapy%intensity - modulated ra-diotherapy
目的:探讨非小细胞肺癌(NSCLC)脑转移调强放射治疗的临床疗效和毒性反应。方法:72例 NSCLC 脑转移患者采用共面5野同步补量(SIB)调强放疗(IMRT)进行治疗,全脑放疗(WBRT)剂量,DT40 Gy,每次2 Gy,每周5次,共20次,脑转移灶(PTV - GTV)同步加量,DT 50~60 Gy,每次2.5~3.0 Gy,共20次。95%的等剂量曲线包括靶区。放疗结束后1个月行脑部增强 MRI 或 CT 评价疗效。结果:完全缓解(CR)6例(8.3%),部分缓解(PR)57例(79.2%),疾病稳定(SD)5例(6.9%),进展(PD)4例(5.6%)。治疗有效率87.5%(63/72)。全组中位生存期为13个月。1,2年生存率分别为54.2%和23.6%。主要毒副反应为恶心呕吐、脑水肿等。结论:IMRT 治疗 NSCLC 脑转移有较好的疗效,毒副反应可耐受。
目的:探討非小細胞肺癌(NSCLC)腦轉移調彊放射治療的臨床療效和毒性反應。方法:72例 NSCLC 腦轉移患者採用共麵5野同步補量(SIB)調彊放療(IMRT)進行治療,全腦放療(WBRT)劑量,DT40 Gy,每次2 Gy,每週5次,共20次,腦轉移竈(PTV - GTV)同步加量,DT 50~60 Gy,每次2.5~3.0 Gy,共20次。95%的等劑量麯線包括靶區。放療結束後1箇月行腦部增彊 MRI 或 CT 評價療效。結果:完全緩解(CR)6例(8.3%),部分緩解(PR)57例(79.2%),疾病穩定(SD)5例(6.9%),進展(PD)4例(5.6%)。治療有效率87.5%(63/72)。全組中位生存期為13箇月。1,2年生存率分彆為54.2%和23.6%。主要毒副反應為噁心嘔吐、腦水腫等。結論:IMRT 治療 NSCLC 腦轉移有較好的療效,毒副反應可耐受。
목적:탐토비소세포폐암(NSCLC)뇌전이조강방사치료적림상료효화독성반응。방법:72례 NSCLC 뇌전이환자채용공면5야동보보량(SIB)조강방료(IMRT)진행치료,전뇌방료(WBRT)제량,DT40 Gy,매차2 Gy,매주5차,공20차,뇌전이조(PTV - GTV)동보가량,DT 50~60 Gy,매차2.5~3.0 Gy,공20차。95%적등제량곡선포괄파구。방료결속후1개월행뇌부증강 MRI 혹 CT 평개료효。결과:완전완해(CR)6례(8.3%),부분완해(PR)57례(79.2%),질병은정(SD)5례(6.9%),진전(PD)4례(5.6%)。치료유효솔87.5%(63/72)。전조중위생존기위13개월。1,2년생존솔분별위54.2%화23.6%。주요독부반응위악심구토、뇌수종등。결론:IMRT 치료 NSCLC 뇌전이유교호적료효,독부반응가내수。
Objective:Through the observation outcomes with intensity - modulated radiotherapy to explore the efficacy and toxicities of intensity - modulated radiotherapy to treat the brain metastases of non - small cell lung cancer. Methods:A to-tal of 72 non - small cell lung cancer(NSCLC)patients were treated by intensity - modulated radiotherapy(IMRT)with five coplanar beams using simultaneous integrated boost(SIB)technique from May 2008 to November 2012. The prescription dose was 50 ~60 Gy(PTV - G:brain metastases)and 40 Gy by whole - brain irradiation therapy(WBRT)in 20 fractions. Response was evaluated by contrast - enhanced brain MRI or CT one month after the end of radiotherapy. The 95% equi - dosage line in-clude the target area. Results:The complete remission(CR)of imaging was 8. 3% ,partial remission(PR)was 79. 2% ,stable disease(SD)was 6. 9% and progressive disease(PD)was 5. 6% . The effective rate was was 87. 5%(63 / 72). The overall median survival was 13 months. The 1 - year and 2 - years survival rate were 54. 2% and 23. 6% . The main toxicities were nausea and vomiting,brain edema. Conclusion:Intensity - modulated radiotherapy is highly effective and well tolerated in treat-ment of NSCLC with brain metastases. It may be worthy of further clinical investigation and application.