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目的 探讨预防性全脑照射对局限期小细胞肺癌脑转移率和生存率的影响。方法 51例经化疗加放射治疗后完全缓解的局限期小细胞肺癌病例被随机分为脑照射组 (2 6例 )和对照组 (2 5例 )。脑照射组在肿瘤完全缓解后 1 1～ 58d开始常规分割照射 ,采用双侧野照射 ,剂量为 2 5 .2～ 30 .6Gy。结果 脑照射组脑转移率为 3 .8% ,明显低于对照组的 32 .0 % (χ2 =5 .1 5 ,P =0 .0 2 )。脑照射组1、3、5年生存率分别为 84.6 %、42 .3 %、34 .6 % ,对照组分别为 72 .0 %、32 .0 %、2 4 .0 % ,两组比较差异无显著性意义 (χ2 =2 .2 5 ,P =0 .1 3)。脑照射组没有出现严重的放射后遗症。结论 预防性全脑照射能减少局限期小细胞肺癌的脑转移 ,可能有提高其生存率的趋势
Objective To investigate the effect of prophylactic whole brain irradiation on brain metastasis and survival rate in patients with localized small cell lung cancer. Methods A total of 51 patients with locally advanced small cell lung cancer (NSCLC) who underwent complete remission after chemotherapy and radiotherapy were randomly divided into a brain irradiation group (26 cases) and a control group (25 cases). Cerebral irradiation group in the complete remission 1 1 ~ 58d after the start of conventional split irradiation, the use of bilateral field irradiation, a dose of 25.2 ~ 30.6 Gy. Results Brain metastasis was 3. 8% in brain irradiation group, which was significantly lower than 32.0% in control group (χ2 = 5.15, P = 0.022). The 1, 3, 5-year survival rates in brain irradiation group were 84.6%, 42.3% and 34.6% respectively, while those in control group were 72.0%, 32.0% and 24.0% respectively. There was significant difference between the two groups No significant (χ2 = 2.25, P = 0.13). There was no serious radiation sequelae in the brain irradiation group. Conclusion Prophylactic whole brain irradiation can reduce the brain metastasis of SCLC and may have the tendency of increasing its survival rate