| 后程超分割放射治疗局部晚期非小细胞肺癌的临床研究 |
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| 作者：程晶，伍… 文章来源：《中国癌症杂志》 点击数： 更新时间：2005-5-17 |
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[摘要] 目的：探讨后程超分割放疗在局部晚期非小细胞肺癌(NSCLC)治疗中的作用和毒性。
方法：将74例Ⅲ期NSCLC患者随机分成2个组：(1)常规分割(CF)组：2.0 Gy/次，5次/周，大野照射至40 Gy时，缩野针对临床肿瘤区加量照射，总剂量为65~70 Gy/33~35次；(2)后程超分割(LCH)组：先常规照射40 Gy，后程缩野后1.2Gy/次，2次/天，2次间隔6小时，5天/周，共10个治疗日，照射量24Gy，总剂量为64Gy/40～42次。
结果：LCH组和CF组的有效率分别为78.4％(29/37)和62.2％(23/37)，有显著性差异(P<0.05)；随访5年，LCH组的前3年局部控制率和生存率分别为70.3%、48.6%、27.0%和75.7%、59.5%、32.4%，较CF组相应的56.8%、21.6%、5.4%和62.2%、27.0%、16.2%均有显著性差异（P<0.05）；但两组的五年生存率无显著性差异。而放疗毒性反应发生率除放射性食管炎外两组无明显差异。
结论：后程超分割放疗能提高局部晚期NSCLC的近期疗效、局控率和生存率；但远期生存率无明显改善。
[关键词] 非小细胞肺癌；后程超分割；放射疗法；晚期
[Abstract] Purpose：To evaluate the clinical effect of late-course hyperfractionated (LCH) radiotherapy and conventionally fractionated (CF) radiotherapy for local advanced non-small cell lung cancer (NSCLC).
Methods：From August 1995 to April 1998, 74 patients with inoperable stage Ⅲ NSCLC were randomized into two groups: CF and LCH. 37 patients in CF group received a fraction of 2 Gy daily, 5 days per week, to the total dose of 65～70 Gy /6.5～7 weeks. 37 patients in LCH group were treated with the same fractionation as CF group to the dose of 40 Gy, and then followed by LCH radiotherapy: 1.2Gy, twice daily, with the interval of 6 hours between fractions, to the total dose of 64 Gy/6 weeks.
Results：The overall response rate in LCH group and CF group were 78.4％(29/37) and 62.2％(23/37) respectively, the difference was significant (P<0.05). The l-,2-,3-year local control rates and survival rates were respectively 70.3%、48.6%、27.0% and 75.7%、59.5%、32.4% in LCH group, and 56.8%、21.6%、5.4% and 62.2%、27.0%、16.2% in CF group (P<0.05). Howerver, the 5-year survival rates in LCH group and CF group were both 5.4%, there was no difference. The incidence of esophagitis in LCH group was 81.1％(30/37),and in CF group was 54.1％(18/37),P<0.05.
Conclusions：The late-course hyperfractionated radiotherapy can improve the overall response rate, 1～3 year local control rates and survival rates with minimal radiation reactions, but it may not improve the 5year survival rate.
[Key words] non-small cell lung cancer；radiotherapy；late-course hyperfraction；advanced
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