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目的观察放疗+热疗肺肿瘤≥5 cm的非小细胞肺癌(NSCLC)近期疗效和副反应。方法NSCLC满足肿瘤最小径≥5 cm或体积≥125 cm3及其他入组条件后,接受放疗+热疗。共30例进入研究组,其中男23例,女7例;中位年龄61岁(32~81岁);鳞癌22例,腺癌8例;Ⅰb期6例,Ⅱb期1例,Ⅲa期10例,Ⅲb期8例,Ⅳ期5例。肿瘤中心温度43.0~43.5℃,为智能控温方式。热疗结束后1 h内行放疗,总剂量60~66 Gy,分30~33次。结果平均肿瘤体积275.45 cm3(125~900 cm3),平均加热次数7.2次(2~14次),平均放射剂量59.10 Gy(23.96~69.67 Gy)。5例未完成放疗计划,治疗中断原因与治疗方案的副反应无关。在加热过程中,无患者主诉胸闷气急或气急加重,呼吸、血压、脉搏在加热前后无明显变化。无一发生皮肤水泡及皮下脂肪硬化。无3级以上急性放射性反应。CR率为23%,PR率为50%,NC率为27%,PD率为0%。局部控制率为83%,中位局部控制时间19.2个月。死亡11例,2例死于局部肿瘤复发咯血,其中1例未完成治疗计划。中位生存期19.7个月,1年生存率为75%。结论放疗+热疗用于肿瘤≥5 cm的NSCLC,有较好的近期疗效和局部控制率,无严重副反应,是一种可选择的治疗方案。
Objective To observe the short-term curative effect and side effects of non-small cell lung cancer (NSCLC) with radiotherapy + hyperthermia lung tumor≥5 cm. Methods NSCLC to meet the tumor minimum diameter ≥ 5 cm or volume ≥ 125 cm3 and other conditions into the group after receiving radiotherapy + hyperthermia. A total of 30 patients entered the study group, including 23 males and 7 females; the median age was 61 years (32 to 81 years); squamous cell carcinoma in 22 cases, adenocarcinoma in 8 cases; Ⅰ b in 6 cases, Ⅱ b in 1 case, Ⅲ a 10 cases, Ⅲ b in 8 cases, 5 cases in stage Ⅳ. Tumor center temperature 43.0 ~ 43.5 ℃, intelligent temperature control. Radiotherapy within 1 h after the end of hyperthermia, the total dose of 60 ~ 66 Gy, 30 to 33 times. Results The average tumor volume was 275.45 cm3 (125-900 cm3), the average number of heating times was 7.2 times (2-14) and the average radiation dose was 59.10 Gy (23.96-69.67 Gy). 5 cases did not complete the radiotherapy plan, the reasons for the interruption of treatment and treatment of side effects have nothing to do. In the heating process, no patient complained of chest tightness, shortness of breath or aggravated, breathing, blood pressure, pulse in the heating before and after no significant change. None of the skin blisters and subcutaneous fat sclerosis. No grade 3 or more acute radioactive reaction. The CR rate was 23%, the PR rate was 50%, the NC rate was 27% and the PD rate was 0%. The local control rate was 83%, the median local control time 19.2 months. 11 died, 2 died of local tumor recurrence of hemoptysis, 1 of which did not complete the treatment plan. The median survival was 19.7 months, and the 1-year survival rate was 75%. Conclusion Radiotherapy + hyperthermia is an alternative treatment for NSCLC with tumor of more than 5 cm, with good short-term curative effect and local control rate, without serious side effects.