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目的 了解老年人非小细胞肺癌 ( NSCLC)放射治疗临床特点。 方法 对 1 3 5例完成根治性放疗的老年 NSCLC患者施行常规和非常规分割放疗 ,其中 52例在放疗前或 (和 )放疗后接受中位数 2周期 ( 1～ 9周期 )的化疗。 结果 按时完成放疗者 89例 ,4 4例疗程有中断。总的 1、2、3年生存率分别为 76%、3 9%、2 3 %;局部控制率分别为 64 %、4 2 %、4 0 %;无远处转移者 1、2、3年生存率分别为 70 %、52 %、3 6%。3 3 %( 44 /1 3 5)未接受连续放疗 ,中断原因 :患者不能耐受 3 1例 ,化疗 4例 ,其他 9例。不同放疗分割方式及辅助化疗对疗程中断无影响 ( P>0 .0 5)。放疗连续组与中断组比较 ,放疗疗程中断明显影响生存率 ( P<0 .0 5)、局控率 ( P<0 .0 1 )。 结论 老年 NSCLC完成根治性放疗后有较好的疗效。部分患者对根治性放疗耐受性较差 ,与放疗分割方式及非正规化疗无关。放疗耐受性差的患者预后较差。
Objective To understand the clinical features of radiotherapy for elderly patients with non-small cell lung cancer (NSCLC). Methods One hundred and thirty-five elderly patients with NSCLC who underwent curative radiotherapy were treated with conventional and unconventional fractionated radiotherapy. Fifty-two patients received radiotherapy with a median of 2 cycles (1 to 9 cycles) before radiotherapy or (and) after radiotherapy. Results 89 patients completed radiotherapy on time, and 44 patients had interruption of treatment. The overall 1-, 2-, and 3-year survival rates were 76%, 39%, and 2%, respectively; the local control rates were 64%, 44%, and 40%, respectively; there were no distant metastases for 1, 2, and 3 years. The survival rates were 70%, 52%, and 36%. 3 3% (44/135) did not receive continuous radiotherapy. The reasons for the interruption were: patients could not tolerate 31 cases, chemotherapy 4 cases, and other 9 cases. Different fractionation of radiotherapy and adjuvant chemotherapy had no effect on treatment interruption (P>0.05). In the continuous radiotherapy group and the interrupted group, radiotherapy interruption significantly affected the survival rate (P<0.05) and local control rate (P<0.01). Conclusion Elderly NSCLC has good curative effect after radical radiotherapy. Some patients have poor tolerance to radical radiotherapy and have nothing to do with radiotherapy segmentation and informal chemotherapy. Patients with poor radiotherapy tolerance have a poor prognosis.