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为了探讨体部伽玛刀治疗局部晚期非小细胞肺癌临床疗效及影响因素,363例Ⅲ期NSCLC患者采用OUR-QGD型体部伽玛刀治疗。单次治疗剂量为3.0～5.5Gy,等剂量曲线50.0%～75.0%,计划靶体积(PTV)覆盖>95.0%临床靶体积(CTV),共计8～14次。根据患者年龄、KPS评分、肿瘤侵及范围、CTV、治疗中毒副反应调整治疗剂量。治疗结束后3个月复查,近期有效率(CR+PR)ⅢA期为85.8%,ⅢB期为81.8%。KPS评分、肿瘤大小和病理类型为影响近期疗效的临床因素。KPS评分<80、CTV≥60cm3和腺癌患者疗效差。急性放射毒副反应均较小。1、2年生存率分别为53.2%、26.6%。体部伽玛刀治疗局部晚期NSCLC,可以使肿瘤局部得到准确的高剂量照射,近期疗效显著,毒副反应小,可延长患者生存期,提高患者生存质量。
In order to explore the clinical efficacy and influencing factors of gamma knife in the treatment of locally advanced non-small cell lung cancer, 363 patients with stage Ⅲ NSCLC were treated with OUR-QGD type gamma knife. The single treatment dose was 3.0-5.5 Gy and the isodose curve was 50.0-75.0%. The planned target volume (PTV) covered> 95.0% of the clinical target volume (CTV) for a total of 8-14 sessions. The therapeutic dose was adjusted according to patient’s age, KPS score, tumor invasion range, CTV, and treatment side effects. Three months after the end of treatment review, the recent effective (CR + PR) Ⅲ A 85.8%, Ⅲ B 81.8%. KPS score, tumor size and pathological type are the clinical factors affecting the short-term efficacy. KPS score <80, CTV ≥ 60cm3 and poor efficacy of patients with adenocarcinoma. Acute radiation toxicity are minor. The 1-year and 2-year survival rates were 53.2% and 26.6% respectively. Body gamma knife treatment of locally advanced NSCLC, the tumor can get accurate high-dose local irradiation, the recent significant effect, small side effects, can extend the patient’s survival and improve patient quality of life.