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目的分析三维适形放疗(3DCRT)在非小细胞肺癌(NSCLC)治疗中的效果和放射损伤情况,并分析其预后因素。方法接受3DCRT的91例NSCLC中男73例,女18例,中位年龄66岁。放疗中位单次剂量2Gy,5次/周,中位总剂量60Gy,中位随访期17个月。结果完全缓解11.0%(10/91),部分缓解46.2%(42/91),稳定33.0%(30/91),进展1.1%(1/91),有效率57.1%(52/91)。1、2年总生存率分别为67.0%、32.6%,中位生存期16个月。1、2年的无局部进展生存率分别为82.6%、53.0%。单因素和多因素分析都显示,体重下降≥5%预后不良。急性放射性肺炎2级2例,3级4例;晚期放射性肺炎2级1例,3级1例。急性放射性食管炎2级8例。急性2级骨髓毒性5例。结论3DCRT治疗NSCLC有很好的近期疗效,放射损伤在可接受范围。放疗总剂量还有提升的空间。
Objective To analyze the effect of three-dimensional conformal radiotherapy (3DCRT) on the treatment of non-small cell lung cancer (NSCLC) and its radiation injury, and analyze its prognostic factors. Methods Ninety-one male and female patients were enrolled in 91 NSCLC patients undergoing 3DCRT. The median age was 66 years. The median single dose of radiotherapy 2Gy, 5 times / week, the median total dose of 60Gy, the median follow-up period of 17 months. The results were 11.0% (10/91) in complete remission, 46.2% (42/91) in partial remission, 33.0% (30/91) in stable remission, 1.1% (1/91) in progress, and 57.1% (52/91) in remission. The 1-year and 2-year overall survival rates were 67.0% and 32.6% respectively, with a median survival of 16 months. The progression-free survival rates in 1 and 2 years were 82.6% and 53.0% respectively. Univariate and multivariate analyzes showed a 5% weight loss with poor prognosis. Grade 2 acute radiotherapy pneumonia in 2 cases, 3 cases in 4 cases; 2 cases of advanced radiation pneumonitis in 2 cases, 3 cases in 1 case. Acute radiation esophagitis grade 2 8 cases. Acute grade 2 myelotoxicity in 5 cases. Conclusions 3DCRT has a good short-term effect in the treatment of NSCLC, with acceptable radiation exposure. The total dose of radiotherapy there is room for improvement.