摘要:
目的: 探讨提高放射治疗老年非小细胞肺癌(non-small celllung cancer,NSCLC)疗效的方法。方法: 对1998年11月~2000年12月83例60岁以上老年NSCLC患者按信封法随机分为治疗组(常规加三维适形放疗)和对照组(常规放疗)。两组常规放疗方法相同,先设前后对穿野,20次(5次/周)共照射DT 40 Gy,,治疗组用三维适形放疗每次补充DT 3 Gy,5次/周,共DT 24 Gy,对照组仍用常规放疗避开脊髓共补充DT 20 Gy,5次/周,2周。结果: 治疗组3年生存率为36.6%,优于对照组的14.3%(P<0.05),治疗组无Ⅲ、Ⅳ级急性放射性食管炎,急性放射性肺炎和晚期放射性肺纤维化发生率为7.3%和39%。结论: 常规加三维适形放射治疗可提高老年人NSCLC患者的3年生存率,同时降低急性及晚期放射反应。
Abstract:
Objective: To evaluate the effect of radiotherapy on non-small-cell lung cancer(NSCLC) in the elderly.Methods: From Nov.1998 to Dec.2000,83 patients over sixty were randomized into conventional radiotherapy plus three-dimmentional conformal radiotherapy(3DCRT) group and conventional radiotherapy(CT) group.The two groups were initially treated by the same conventional radiotherapy at a dose of 40 Gy,20 fractions for four weeks.The patients in 3DCRT group were then administered 3DCRT in 3.0 Gy/f,5 fractions a week at a dose of 24 Gy.The patients in CT group received the same CT at a dose of 20 Gy,10 fractions for two weeks.Results: The 3-year survival rates were 36.6% in the 3DCRT group and 14.3% in the CT group.The difference of the two groups was significant(P<0.05).There was no grade Ⅲ or Ⅳ radiation esophagitis in the 3DCRT group.The incidences of acute radiation pneumonitis and radiation pulmonary fibrosis was 7.3% and 39% respectively in the 3DCRT group.Conclusions: In treatment of NSCLC in the elderly,conventional radiotherapy followed by 3DCRT may increase the 3-year survival rate and decrease the acute and late radiation reaction.
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