CAJ | 학술논문

目的：研究寡转移NSCLC行胸内病灶根治性同期放化疗后巩固化疗的疗效和不良反应。方法2008—2013年间转移灶≤5个的NSCLC患者66例入组。放疗采用IGRT，常规分割或大分割。同期及巩固化疗均以铂类为基础两药联合方案。治疗结束后评价患者近期疗效、不良反应和生存率。结果64例完成治疗。胸内病灶PTV中位BED为72 Gy，中位化疗周期数4个。胸内病灶客观缓解率为70％。随访率为97％。1、2、3年OS分别为72％、53％、31％，中位OS时间25个月；1、2、3年PFS分别为56％、26％、7％，中位PFS时间14个月。2＋3级急性放射性肺炎、放射性食管炎发生率分别为11％和17％，3＋4级白细胞、血红蛋白、血小板计数减少率分别为39％、11％、16％。结论寡转移NSCLC胸内病灶根治性放疗联合同期化疗及巩固化疗，可获得较好近期疗效和长期生存，不良反应可耐受。
목적：연구과전이NSCLC행흉내병조근치성동기방화료후공고화료적료효화불량반응。방법2008—2013년간전이조≤5개적NSCLC환자66례입조。방료채용IGRT，상규분할혹대분할。동기급공고화료균이박류위기출량약연합방안。치료결속후평개환자근기료효、불량반응화생존솔。결과64례완성치료。흉내병조PTV중위BED위72 Gy，중위화료주기수4개。흉내병조객관완해솔위70％。수방솔위97％。1、2、3년OS분별위72％、53％、31％，중위OS시간25개월；1、2、3년PFS분별위56％、26％、7％，중위PFS시간14개월。2＋3급급성방사성폐염、방사성식관염발생솔분별위11％화17％，3＋4급백세포、혈홍단백、혈소판계수감소솔분별위39％、11％、16％。결론과전이NSCLC흉내병조근치성방료연합동기화료급공고화료，가획득교호근기료효화장기생존，불량반응가내수。
Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non?small cell lung cancer ( NSCLC) . Methods Sixty?six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image?guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum?based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short?term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty?four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The objective response rate for thoracic lesions was 70%. The follow?up rate was 97%. The 1?, 2?, and 3?year overall survival ( OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months;the 1?, 2?, and 3?year progression?free survival ( PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2?3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3?4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short?term outcome and long?term survival, with tolerable adverse effects.