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目的评价立体定向放射治疗Ⅱ期(T3N0M0)非小细胞肺癌的疗效和放射反应。方法对46例II期(T3N0M0)非小细胞肺癌患者采用全身伽玛射线立体定向放射治疗系统进行立体定向放射治疗。剂量(50%剂量线)4~5Gy次/,隔日1次,共8~10次,总剂量40~50Gy。结果46例患者总有效率为89.1%(41/46),其中完全缓解率为52.2%(24/46),1、2年总生存率分别为82.6%(38/46)、71.7%(33/46),2年无复发生存率分别为69.6%(32/46)和65.2%(30/46)。早期放射反应主要为骨髓抑制和肺的早期放射反应,骨髓抑制8例(I度5例,II度3例),主要是白细胞和血小板减少;肺的早期放射反应6例(I级4例,II级2例)。晚期放射反应主要为照射区域局限性放射性肺炎,I~II级放射性肺炎16例,III级放射性肺炎7例,食道、心脏、脊髓未观察到晚期放射反应。结论全身伽玛射线立体定向放射治疗系统治疗II期(T3N0M0)非小细胞肺癌患者近期疗效好,放射反应轻,其远期疗效和晚期放射损伤有待于进一步观察。
Objective To evaluate the efficacy and radiotherapy of stereotactic radiotherapy in stage Ⅱ (T3N0M0) non-small cell lung cancer. Methods 46 cases of stage II (T3N0M0) non-small cell lung cancer patients were treated with stereotactic radiotherapy using whole-body gamma-ray stereotactic radiotherapy system. Dose (50% dose line) 4 ~ 5Gy times /, every other day, a total of 8 to 10 times, the total dose of 40 ~ 50Gy. Results The total effective rate was 89.1% (41/46) in 46 patients, of which the complete remission rate was 52.2% (24/46). The overall 1 and 2 year overall survival rates were 82.6% (38/46) and 71.7% (33% / 46). The 2-year recurrence-free survival rates were 69.6% (32/46) and 65.2% (30/46), respectively. Early radiation was mainly bone marrow suppression and early lung radiation response, bone marrow suppression in 8 cases (I degrees in 5 cases, II degrees in 3 cases), mainly leukopenia and thrombocytopenia; early lung radioactivity in 6 cases (I grade 4 cases, II grade 2 cases). The late radiation reaction was mainly localized radiation pneumonitis in irradiation area. There were 16 cases of grade I ~ II radiation pneumonitis and 7 cases of grade III radiation pneumonitis. No esophageal, cardiac and spinal cord radiation was observed in late stage. Conclusion The systemic gamma-ray stereotactic radiotherapy system for treatment of stage II (T3N0M0) non-small cell lung cancer patients with short-term curative effect, radiation reaction, its long-term efficacy and advanced radiation injury needs further observation.