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目的评价三维适形放疗联合化疗(3D-CRT)治疗局部晚期非小细胞肺癌(NSCLC)的近期疗效和急性毒副反应。方法收集2002年4月至2005年12月晚期非小细胞肺癌患者100例,分为三维适形放疗+化疗(A组)50例,常规放疗+化疗(B组)50例。A、B组化疗方案相同,泰素135mg/m2,顺铂70mg/m2,第1、29、57天。A组三维适形放疗放射源为6MV-X线,2Gy/(次·d),40Gy后缩野加量,总剂量DT66～70Gy。B组常规放疗。结果晚期非小细胞肺癌患者经3个月治疗后,Ⅰ、Ⅱ、Ⅲ期CT改变≥50%(11.1%、26.9%、76.9%)与CT改变消失(88.9%、73.3、7.7%),两者比较有显著性差异(χ2=6.70,χ2=6.69,χ2=70.1,P<0.01);鳞癌3年生存率(60.8%)明显高于腺癌(50.0%)两者比较有显著性差异(χ2=4.10,P<0.05);A组有效率(78.0)%明显高于B组(66.0)%(χ2=4.23,P<0.05);A组2年生存率(48.0)%高于高于B组(34.0)%(χ2=4.29,P<0.05);鳞癌有效率(60.0%)高于腺癌(48.4%)(χ2=4.12,P<0.05);放射性肺炎、食道炎、白细胞减少发生率分别为19例(19.0%)、7例(9.0%)、10例(10.0%)。结论3D-CRT联合化疗能提高局部晚期非小细胞肺癌的近期疗效,且急性毒副反应无明显增加。
Objective To evaluate the short-term efficacy and acute side effects of three-dimensional conformal radiotherapy combined with chemotherapy (3D-CRT) in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods One hundred patients with advanced non-small cell lung cancer from April 2002 to December 2005 were enrolled. They were divided into three groups: 50 cases of three-dimensional conformal radiotherapy and chemotherapy (group A) and 50 cases of conventional radiotherapy and chemotherapy (group B). A, B group chemotherapy the same, Taxol 135mg / m2, cisplatin 70mg / m2, the first 1,29,57 days. A group of three-dimensional conformal radiotherapy radiation source for the 6MV-X line, 2Gy / (times · d), 40Gy reduction after the dose, the total dose of DT66 ~ 70Gy. Group B conventional radiotherapy. Results The CT changes in stage Ⅰ, Ⅱ, and Ⅲ were no more than 50% (11.1%, 26.9%, 76.9%) and disappeared after CT treatment (88.9%, 73.3%, 7.7%) after 3 months of treatment in patients with advanced non-small cell lung cancer (Χ2 = 6.70, χ2 = 6.69, χ2 = 70.1, P <0.01). The 3-year survival rate of squamous cell carcinoma (60.8%) was significantly higher than that of adenocarcinoma (50.0%), there was a significant difference (χ2 = 4.10, P0.05). The effective rate (78.0%) in group A was significantly higher than that in group B (66.0%) (χ2 = 4.23, P0.05) (34.0%) in group B (χ2 = 4.29, P <0.05). The effective rate of squamous cell carcinoma was 60.0% higher than that of adenocarcinoma (48.4%) (χ2 = 4.12, P 0. 05). Radiation pneumonitis, esophagitis, leukocyte The incidence of reduction was 19 (19.0%), 7 (9.0%) and 10 (10.0%), respectively. Conclusion 3D-CRT combined with chemotherapy can improve the short-term curative effect of locally advanced non-small cell lung cancer with no obvious increase of acute toxicity.