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目的 观察三维适形放疗治疗非小细胞肺癌的近期疗效及毒性反应,探索三维适形放疗治疗非小细胞肺癌的合适剂量。方法 采用三维适形放疗治疗1 8例非小细胞肺癌。其中首次治疗1 2例,术后复发4例,放疗后复发2例。螺旋CT扫描定位,利用深圳威达公司“CFMTPS2 0 0 0”三维适形放疗计划系统制作三维适形放疗计划,设4～6个共面或非共面射野,靶区(PTV)包括肿瘤(GTV)外1 .5～2 .0cm范围的肺组织,利用剂量-体积直方图评价放疗计划,要求80 %等剂量线包括95 %以上的PTV ,处方剂量在80 %等剂量线上。结果 1 8例患者CR 3例,PR 1 0例,NR 5例,总有效率(CR +PR) 72 .2 %。中位随访时间1 2 .5个月( 4～30个月) ,1年总生存率为80 .8% ,无进展生存率5 3.85 %。全组病人仅1例发生3级食道损伤,无3级肺损伤。结论 三维适形放疗治疗非小细胞肺癌,近期疗效满意,剂量扩增至80～90Gy是安全的。
Objective To observe the short-term curative effect and toxicity of three-dimensional conformal radiotherapy for non-small cell lung cancer (NSCLC) and explore the appropriate dose of three-dimensional conformal radiotherapy for non-small cell lung cancer. Methods Three-dimensional conformal radiotherapy for 18 cases of non-small cell lung cancer. One of the first treatment of 12 cases, 4 cases of recurrence, recurrence after radiotherapy in 2 cases. Spiral CT scan positioning, the use of Shenzhen ICP “CFMTPS2 0 0 0” three-dimensional conformal radiotherapy planning system to make three-dimensional conformal radiotherapy plan, set 4 to 6 coplanar or non-coplanar field, the target area (PTV) (GTV) outside the range of 1.5 ~ 2.0cm lung tissue dose-volume histogram to evaluate the radiotherapy plan requires 80% of the isodose line including more than 95% of the PTV, prescription dose in the 80% isodose line. Results CR was found in 18 patients, PR 10 and NR 5, with a total effective rate (CR + PR) of 72.2%. The median follow-up time was 12.5 months (range 4-30 months). The 1-year overall survival rate was 80.8% and the progression-free survival rate was 3.85%. Only one patient in the entire group developed grade 3 esophageal injury without grade 3 lung injury. Conclusion Three-dimensional conformal radiotherapy for non-small cell lung cancer, the recent satisfactory results, dose expansion to 80 ~ 90Gy is safe.