摘要
目的观察体部立体定向放射治疗（sBRT）周围型肺癌的近期疗效和副反应。方法46例周围型肺癌患者行静态调强适形放疗（IMRT），DT50Gy／4fx／2W，2～3次／N，95％以上PTV满足处方剂量，90％的处方等剂量线完全覆盖PTV，最大剂量点在靶区内，并控制在10％以内，严格控制肺V5〈55％，V20〈20％，心脏和脊髓等危及器官受量控制在正常范围，所有患者在投照前均行摄片和锥形束cT（cB（了）精度验证和配准。随访观察患者放疗的副反应和近期疗效。结果治疗后3～36个月，所有患者均获得随访，中位随访时间18个月，其中完全缓解（CR）率为50％（23／46），部分缓解（PR）率为43．5％（20／46），总有效率为93．5％（43／46）。1年生存率为94．7％（36／38），1年局控率为100％（38／38），2年生存率为52％（13／25），2年局控率为84％（21／25）；放疗期间未出现严重的放疗副反应，放射性肺炎发生率为4．35％（2／46），为Ⅱ级以下，未出现严重的Ⅲ级和Ⅳ放射性肺炎，出现3例肋骨疼痛。结论周围型肺癌行SBRT能够有效地提高肺癌的局部控制率和生存率，且并发症发生率较低，值得临床推广应用。
Objective To Observe the side effect and the recent curative effect of stereotac- tic body radiotherapy （SBRT） treatment for tile peripheral lung cancer. Methods 46 cases of pe- ripheral lung cancer patients were treated with static intensity - modulated radiotherapy （IMRT）, DT50Gy/4fx/2W, 2- 3 times a week, more than 95 % PTV meet the prescribed dose, 90 % of the prescription isodose line complete coverage of PTV, the maximum dose in the target area, and was controlled within 10 %, and strictly control the lung V5 〈 55 %, V20 〈 20 %, heart and spinal cord organ at risk by volume control in the normal range, all patients in the projection of radiogra- phy and cone beam CI＂ （CBCT） precision verification and registration. Observation and follow- up of patients were be with side effects of radiotherapy and efficacy . Results All patients were fol- lowed up after treatment for 3--36 months, the mean follow - up time was 18 months, complete remission （CR） rate of 50% （23/46）, partial remission （PR） rate was 43.5% （20/46）, the total effective rate was 93.5% （43/46）. The i year survival rate was 94.7% （36/38）, 1 years local con- trol rate was 100% （38/38）, the 2 year survival rate was 52% （13/25）, 2 years local control rate was 84% （21/25）; there was no serious radiotherapy side reaction during radiotherapy, radiation pneumonitis occurrence rate is 4.35 % （2/46）, H the following, no serious class Ill and lVof ra- dioactive pneumonia, there were rib pain of 3 cases. Conclusion The local control rate and sur- vival rate can effectively improve using SBRT for peripheral lung cancer, there were lower rate of complications.
出处
《实用临床医药杂志》
CAS
2013年第21期178-180,共3页
Journal of Clinical Medicine in Practice
基金
江苏省无锡市科技局科技支撑社会发展基金(CSE01N1223)
关键词
周围型肺癌
体部立体定向放射治疗
近期疗效
Peripheral lung carcinoma
Stereotactic body radiation therapy
curative effect
