不同剂量分割放疗IIIB期非小细胞肺癌的疗效及毒性比较

Analysis of Efficacy and Toxicity of Different Doses Fraction of Radiotherapy for Stage IIIB Non-Small Cell Lung Cancer

摘要: 目的：比较采用不同剂量分割放疗IIIB期非小细胞肺癌后的疗效及毒性反应。方法：40例IIIB期非小细胞肺癌行三维适形放疗患者，大剂量分割组20例(PTR组)和常规剂量分割组20例(CRT组)，每次治疗前行CBCT扫描验证计划，所有患者均完成处方剂量。计算并比较两组患者放疗后近期疗效及放疗结束3个月内不良反应发生情况。结果：PTR组胸部病灶达CR或PR占40% (8/20)，SD患者占35% (7/20)，PD的患者占25% (5/20)。CRT组胸部病灶达CR或PR占30% (6/20)，SD患者占35% (7/20)，PD的患者占35% (7/20)。所有患者均未出现3~4级不良反应，差异无统计学意义(P > 0.05)。结论：在IIIB期非小细胞肺癌适形放疗中，宜采用大分割放疗，从而提高局控率，缩短疗程，节省时间和资源。

Abstract: Objective: To compare different doses of radiotherapy in phase IIIB non-small cell lung cancer efficacy and toxicity. Methods: 40 cases of phase IIIB non-small cell lung cancer patients who were treated by three-dimensional conformal radiotherapy were randomly divided into high-dose fraction group (PTR) and conventional fraction group (CRT). All patients completed prescription dose with a CBCT scan validation program before each treatment. The short-term effects of radiotherapy and the incidence of adverse events within 3 months after radiotherapy were calculated and compared between the two groups. Results: PTR Group chest lesions of CR or PR accounted for 40% (8/20), SD patients accounted for 35% (7/20), and PD patients accounted for 25% (5/20). CRT Group chest lesions of CR or PR accounted for 30% (6/20), SD patients accounted for 35% (7/20), and PD patients accounted for 35% (7/20). No patient experienced grade 3 to 4 adverse events, with no significant difference (P > 0.05). Conclusion: High-dose fraction radiation therapy should be selected in the IIIB non-small cell lung cancer conformal radiotherapy, because it can improve the local control rate, shorten the course of treatment, and save time and resources.